Talk:Heartburn

Generally inaccurate and misleading

This whole article is full of inaccuracies and references that do not support the claims made, notably that 'heartburn' is a symptom of IHD and that it is synonymous with GERD. It really needs to be totally rewritten — Preceding unsigned comment added by 130.56.76.63 (talk) 14:22, 16 July 2012 (UTC)

Ambiguous sentence

"It however may also be a symptom of ischemic heart disease so concluding that it is heartburn prematurely may lead to misdiagnosis."

This suggests that "It" i.e., heartburn, may be a symptom of something else. This, however, is probably not the intended meaning of this sentence. The intended meaning is probably that heartburn and ischemic heart disease share a common set of symptoms and hence there is risk of misdiagnosis. The current text suggests: heartburn is a symptom of ischemic heart disease.

In any case, this should be reworded to avoid such ambiguity and so that it reads better ("It however may ..." bad form, no commas.) —Preceding unsigned comment added by 108.7.10.101 (talk) 02:34, 28 December 2010 (UTC)

More info added

k —Preceding unsigned comment added by 69.50.81.21 (talk) 07:06, 4 October 2007 (UTC) Added short descriptions of diagnostic tests, expanded the treatments section, etc. I wonder if the stub status should be removed....

Some of the changes come from MediPrimer:Heartburn and GERD. As the copyright holder of that text, I authorize the use of this text under the GFDL as part of Wikipedia. Yashka78 20:30, 13 July 2005 (UTC)

Pregnancy

I'm a wikinewbie. Maybe someone could add pregnancy as a cause of hearburn? Reference http://www.babycenter.com/refcap/pregnancy/prenatalhealth/242.html googhie 02:58, 17 October 2006 (UTC)Googhie

Pregnancy can indeed be a cause, but let's leave that site out, it's not a reputable medical source.--Steven Fruitsmaak (Reply) 16:36, 9 November 2006 (UTC)

I'm also a wikinewbie. I can't understand how pregnancy can be simply left out of this page, even if the above is not a reputable medical source. Ask any medical doctor is heartburn is a common condition in pregnancy. BTW I've heard that heartburn is alleviated by lying on the right, since the stomach drains downwards better that way. Further ideas for this page is to explore how pregnancy is associated with heartburn - I heard it is associated with the stomach valve being pushed up (by the expanding uterus) to the upper region of the abdomen, where the pressure induces the acid reflux. Does anyone know if this is true? Accurate awareness of what is going on internally could potentially be helpful to sufferersWikiwhich85 (talk) 09:23, 14 December 2008 (UTC)wikiwhich85

I dont think heartburn should be automatically grouped in with GERD. I have GERD and have never experienced heartburn. Yes it should be listed as a linked symptom and so readers can be redirected.

Merge?

This article is about heartburn, which is a symptom of gastroesophageal reflux disease. Some content needs to be moved there: e.g. the disease is treated, not the symptom: treatment involves making a diagnosis and then treating the cause.--Steven Fruitsmaak (Reply) 16:40, 9 November 2006 (UTC)

• Keep it separate. Heartburn is the most commonly used name, and even if it is a symptom of a technical disease, the symptom is so well-known as to deserve its own article. 129.98.212.164 17:49, 13 November 2006 (UTC)
• Merge it because that will reduce duplication and increase clarity, but the combined article MUST have a section with a discussion of non-Gerd heartburn (i.e., heart attacks) and this really needs to be referenced in the first paragraph of the combined article.
• Keep it separate. Like Bellamorbida below, hearburn is not GERD and GERD is not heartburn. Cburnett 20:40, 25 November 2006 (UTC)
• Heartburn is a symptom - GERD a disease => dont merge.
• Keep it separate. Our daughter has reflux and none of the professional's have ever mentioned heartburn. --JimmyTheWig 14:08, 11 December 2006 (UTC)
• Keep it separate. I have heartburn and have never had GERD.
• Keep it separate. And, for that matter, Acid Reflux should be a separate entry as well. If we merge everything that's related to everything else, Wikipedia will only have one very long entry in it. Heartburn and Acid Reflux are possible symptoms of GERD. Both can occur for other reasons, including eating spicy food. Heartburn and Acid Reflux are related to each other but they are not the same thing. People can have GERD and not experience heartburn. Treatment for non-GERD Acid Reflux and non-GERD Heartburn are not the same as treatment for GERD. I, for one, hate it when I look in Wikipedia for some information and get redirected to some page which is not about what I am looking for and sometimes doesn't even mention the subject. If cross-references are needed, let's put them in.
• Keep it separate. Heartburn should NOT merge with Gerd or vice versa.

Merge?

I agree with all,Heartburn MUST not be confused with GERD,as GERD is a serious medical problem which can lead to choking and death,along with the usual sysmtoms of repeated burning of the esophagus,which if nor treated over time may cause Barrets esophagus and/or cancer.

Heartburn is usaually a sympton of over indulgence of rich food etc,and happens to a person on a realatively occasions basis,not constantly everyday.

NO it should not be merged with the trifling but annoying heartburn with the serious condition of reflux disease,S.W.R

Heartburn should not be merged with GERD as GERD is a more serious condition that generally requires some form of medical treatment or the condition will worsen and can cause permanent damage to the esophogus. Although Heart burn is a sign and/or symptom of GERD, people with heartburn may not always have GERD; and thus do not need to be overconcerned they have some serious medical condition. Bellamorbida 20:08, 16 November 2006 (UTC)

Heartburn is actually a sufficient symptom to diagnose GERD.--Doc James (talk · contribs · email) 18:03, 20 January 2009 (UTC)

"Heartburn" is not. Many people that are nowhere near consideration for GERD experience heartburn. A certain degree of frequency would be necessary (ie. "often" is sufficient). Maybe I'm just being picky with your language, but it is definitely very important to note that one case of heartburn is not sufficient. By the way, I agree that a merge is a bad idea, it would be like merging "headache" with "brain tumor." Perhaps "frequent headaches" is not sufficient to diagnose a brain tumor, but I'm sure you can understand where I'm coming from. _Anonabyss ^{[ Talk ][ Contribs ]}  19:58, 19 February 2009 (UTC)

Water treatment

Someone claimed that logically, water cannot reduce heartburn because of the logarithmic nature of the pH system requiring 10 times the volume of acid to neutralize the pH by one point. This may seem logical, but it is not for certain just off that logic (consider that the volume of acid is not that great in the space of an esophogus. That comment should not be there without a reference. Ichibani 02:37, 19 November 2006 (UTC)

I agree with the above statement. I've had heartburn on numerous occasions when drinking a glass of water did help relieve the effects to an extent. Since the comment only pertains to temporary relief, I think it is useful and should remain.

Water may not significantly change the PH level of the stomach, but it can rinse the acid back out of the esophagus, and back into the stomach where it belongs. The amount of acid in the esophagus which is causing the heartburn is probably only a small amount.--RLent 23:33, 16 January 2007 (UTC)

A source would be good. Not to doubt your experience or anyone else's, but it's hardly scientific. Keeping encyclopedia pages about medical conditions focused on verifiable fact is probably a good call. Ichibani 06:58, 17 January 2007 (UTC)

I disagree, For me water dose not work due to severe GERD. The acid rises into the esophagus water May be temporary relief but adding more contents to your stomach can just make it worse

I would have to disagree with the notion that water might be helpful in treating heartburn, based on my personal experience. In almost all of cases, my heartburn gets worse if I drink a few glasses of water. I suppose this is due to the fact that it becomes easier for the stomach acid

to reach esophagus because of increased gastric valume due to water intake (and also because water apparently does not reduce stomach acidity). 193.217.55.223 03:58, 19 July 2007 (UTC)

There's no source for water treatment. We're not experts and even if we were, it'd be original research to decide whether or not water can help. Considering no advice is better than bad advice, I removed it. If someone brings up a source either way (saying water helps, hurts, or even does nothing) we should definitely add it. Ichibani _u^t_c 04:41, 19 July 2007 (UTC)

Folk Remedies

I removed a collection of folk remedies that were added to the article. An encyclopedia article should not serve as a list of possible treatments that have been suggested. Ichibani 22:03, 29 April 2007 (UTC)

of course it should

wikipedia is the also the repository of common wisdom

if were untrue then yes it should be deleted

I read an item today (6 Feb 2008) which was just deleted and thought :it was:

1. well identified as advice from your grandmother
2. pertinent to the problem which has know cause nor cure
3. logically argued

I think it is cruel to only list what is on pharmacutical websites

is only foolishly pushing big pharma,and worse in the long run will cheapen wikipededia which most people trust to tells the truth

Finally, recommending to drink more water seemed to answer correctlyearlier questions discussed here

-- 88.169.28.67 (talk) 21:58, 6 February 2008 (UTC)

WP:NOT#GUIDE -- Zsero (talk) 22:02, 6 February 2008 (UTC)

Whether or not the remedies work, without a reference from a peer reviewed journal they are essentially useless. I

could say that sand cures tiger bites, because my grandmother told me it did. That doesn't make it wworthy of being

on wikipedia 88.106.82.168 (talk) 00:01, 23 October 2008 (UTC)

Information resource

Please consider adding the National Heartburn Alliance (www.heartburnalliance.org) to your content references and/or the list of resources linked. The site contains a wealth of information written and edited by published academics who are leaders in the GI field (see "about the Board" for information). The site is referenced by the National Institutes of Health online. The site does not link to product sites, but does contain online screener tools that can direct sufferers to the appropriate lifestyle changes and medication options based on the frequency and severity of their symptoms. The site does not contain information on GERD. While I know Wikipedia isn't meant to be a clearinghouse for web links, I believe readers will find the information listed on the site to be helpful. Thank you for considering this information source. Feel free to e-mail us at nhbainformation@heartburnalliance.org for more info or to speak with any of the Board members. —The preceding unsigned comment was added by 63.115.255.28 (talk • contribs).

Diagnosis

Because the symptoms of angina might mimic those of indigestion, perhaps the focus of diagnosis should be to rule out cardiac causes of the symptoms, rather than to confirm heartburn?

____________________________________

69.140.152.55 (talk) 14:12, 31 May 2008 (UTC)

Please improve article!

This article desperately needs:

• a diagram showing where heartburn typically and atypically occurs, superposed on a male and female chest
• a clearer description of what heartburn feels like -- and entire section dedicated to describing it and showing what's going on from an anatomical point of view with pictures —Preceding unsigned comment added by 18.187.0.86 (talk) 21:51, 4 July 2008 (UTC)

Merge

Have suggested we merge this article with GERD. --Doc James (talk · contribs · email) 18:21, 20 January 2009 (UTC)

Have realized that merging is a bad idea. Heartburn is a symptom, GERD is a disease. Page needs to be written to reflect this.Doc James (talk · contribs · email) 23:05, 20 April 2010 (UTC)

Addition of unsourced or poorly sourced claims

The following (almost verbatim) has been inserted into the article a total of seven times over the past three months:

Popular natural remedies include aloe vera juice, apple cider vinegar, and marshmallow root tea.

Sometimes the text is sourced to altmedicine.about.com (not a good source for a medical article, per WP:MEDRS), and sometimes it is completely unsourced. Each addition has been made by the same editor - User:Sdm9093. I have reverted these additions, with my edit summaries indicating the lack of reliable (or, in some cases, any) sources. The edits adding the text back have generally been without edit summaries. Since the pace of these additions has now stepped up (there have been two today), I thought it best to discuss here.

Unsourced or poorly sourced claims should not be added to this (or any) article. If there's a reason why this text is repeatedly added back with no commentary or discussion, now would be a good time to discuss.

So, what's the rationale for why this should be included? Is the only source altmedicine.about.com? If so, why do you feel that is a reliable source for a medical article, given both the policies at WP:RS and the guidelines at WP:MEDRS which seem to say otherwise? -- Transity^{(talk • contribs)} 19:07, 22 September 2009 (UTC)

It appears that User:Sdm9093 has now added the same text back as an IP user User:64.62.15.158. Again, I urge you to discuss this instead of edit warring. -- Transity^{(talk • contribs)} 20:03, 22 September 2009 (UTC)

I'll go ahead and remove it again, then. If you want to re-add it, please discuss here before doing so. Thanks. -- Transity^{(talk • contribs)} 13:01, 25 September 2009 (UTC)

Gastric reflux should redirect here

Gastric reflux should redirect here rather than to the chronic disease. —Preceding unsigned comment added by Kadhumia flo (talk • contribs) 14:33, 23 November 2009 (UTC)

Gastric reflux is a disease this is about a symptom.Doc James (talk · contribs · email) 23:06, 20 April 2010 (UTC)

Rewrite

This page needs to be rewritten. It is presented as a disease rather than as a symptom. Heart burn can sometime represent an MI at which antacids are not the best treatment. GERD is the disease. Heart burn is a type of chest pain. Will work on conveying this distinction over the next week or so. Doc James (talk · contribs · email) 22:35, 20 April 2010 (UTC)

I agree that this page needs to be rewritten. I am going to begin working on this article. I welcome your help with this. CheckDO (talk) 04:13, 18 November 2021 (UTC)

How should we organize this topic area?

This is complicated. 90% of the literature using heart burn interchangeably with GERD. I feel that we should keep them seperate with this being the symptom the other being the disease. This however makes finding good references hard.Doc James (talk · contribs · email) 03:52, 21 April 2010 (UTC)

External Review Comments

The following comments are from an external reviewer BSW-RMH as part of the new joint Wikipedia talk:WikiProject Medicine/Google Project.

Hello Heartburn article writers and editors, This article currently has 'start' status and is a high priority article for the Wikipedia talk:WikiProject Medicine/Google Project. Expansion of this article is seriously hampered by confusion over the definition of the term 'heartburn'. I suggest agreeing on a definition and then expanding the article. Throughout this review I will be using heartburn as meaning the burning sensation in the chest due to acid reflux, because this is the most common meaning of the term in the clinical GI field. Specific suggestions are as follows:

Images

As previously mentioned by others on this page, this article would definitely benefit from the addition of images. Sources for possible images to include are listed here. As far as I can tell, these are in the public domain and do not have copyright restrictions, but someone with more experience in that area should confirm this before adding them to the article.

• http://www.megahowto.com/wp-content/uploads/2010/02/Heartburn.gif
• http://treatheartburn.org/wp-content/uploads/2009/09/Cause-of-Heartburn.jpg
• http://www.riversideonline.com/source/images/image_popup/r7_heartburn.jpg

BSW-RMH (talk) 15:52, 18 May 2010 (UTC)

All of these images pertain to gastric reflux. This is about a symptoms that is not necessarily cause by reflux this I do not think these images are appropriate. Doc James (talk · contribs · email) 16:47, 18 May 2010 (UTC)

Heartburn is the burning chest pain most commonly caused by gastric reflux. With that note, they seem apprpriate to me. Do you have other suggestions of images?BSW-RMH (talk) 16:56, 18 May 2010 (UTC)

Heartburn is the burning sensation in the chest not nessacarily cause by gastric reflux. This paper states "Atypical symptoms such as heartburn, dull pain, and fatigue or symptoms that were intermittent in nature increased delay time" to be seen for an MI. PMID 18340239 Thus it is a symptoms and there are other causes other than gastric reflux. Doc James (talk · contribs · email) 17:04, 18 May 2010 (UTC)

Right, I revised that comment to say it is the most common cause. There are other less common cause, perhaps, but then again it may be a matter of opinion if the chest pains associated with non-gastric reflux causes would be necessarily be categorized as 'heartburn'. I'll try to find some primary research references that resolve this issue for us. BSW-RMH (talk) 17:09, 18 May 2010 (UTC)

WebMD's site on heartburn is well-worded in regards to the issue of differentiating heartburn and the chest pain associated with MI. (http://www.webmd.com/heartburn-gerd/tc/heartburn-topic-overview) We are going to be hard-pressed to find primary research articles discussing the sematics of the term 'heartburn'. BSW-RMH (talk) 21:23, 18 May 2010 (UTC)

Merging

I recommend against merging with GERD, which is a frequent topic of discussion for this article. GERD is the frequent or chronic occurence of heartburn due to gastric reflux that can lead to serious complications and is characterized by esophageal erosion. One can experience heartburn without having GERD. This is well-phrased by the Mayo Clinic page of heartburn, "Heartburn that occurs frequently and interferes with your routine is considered gastroesophageal reflux disease (GERD)."

• http://www.mayoclinic.com/health/heartburn-gerd/DS00095/DSECTION=complications

BSW-RMH (talk) 15:52, 18 May 2010 (UTC)

Would prefer to stick with peer reviewed review articles rather than using the mayo clinic which is not necessarily evidence based or peer reviewed.Doc James (talk · contribs · email) 16:48, 18 May 2010 (UTC)

The Mayo clinic is a reliable source of basic medical information such as signs and symptoms, as is MedlinePlus. I will add some additional textbook sources as time permits, or perhaps you can recommend some. BSW-RMH (talk) 16:59, 18 May 2010 (UTC)

Definition

This section needs to be rewritten based on editor consensus. I recommend that the definition be written as follows to focus on the most common usage of this term (for the public and for gastroenterology clinicians and researchers) to mean a burning sensation in the chest caused by reflux of stomach acid into the esophagus, with mention of other uses. Other uses include referring non-specfically to any burning sensation in the chest, which may be experienced or reported by patients experiencing chest pain caused by other conditions such as heart attacks and and other acute coronary syndromes, gall stone attacks, esophageal attacks. BSW-RMH (talk) 18:07, 18 May 2010 (UTC)

Suggested rewriting of this section:

Heartburn is the burning sensation in the chest commonly caused by digestive stomach acid backing up into the esophagus. The terms dyspepsia (or indigestion) are often used interchangeably with heartburn with dyspepsia being defined as indigestion commonly causing a combination of epigastric pain and heartburn. Chest pain with a burning sensation may also be referred to as 'heartburn' by people experiencing heart attacks or other acute heart syndromes, gallstone attacks, or esophageal spasms.

BSW-RMH (talk) 18:07, 18 May 2010 (UTC)

Differential Diagnosis

Rewritten. BSW-RMH (talk) 17:00, 18 May 2010 (UTC)

Changes may have been changed or reverted and will be reposted here for consideration:

Chest pain can be caused by several conditions and a preliminary diagnosis of heartburn is based on additional signs and symptoms. The chest pain caused by heartburn has a distinct 'burning' sensation, occurs after eating or at night, and worsens when a person lies down or bends over. It also is common in pregnant women, and may be triggered by consuming food in large quantities, or specific foods containing certain spices, high fat content, or high acid content. If the chest pain is suspected to be heartburn, patients may undergo an 'Upper GI series' to confirm the presence of acid reflux.

In the absence of these other signs and symptoms associated with heartburn, other signs and symptoms may indicate that the burning chest pain is associated with other disorders. For example, severe, crushing or burning chest pain combined with difficulty breathing or jaw or arm pain are symptoms of an acute myocardial infarction and angina.. Burning chest pain combined with back pain, shoulder pain, fever, jaundice, or nausea may indicate a gall bladder attack caused by gallstones.. Burning chest pain after eating or drinking and combined with difficulty swallowing may indicate esophageal spasms.

It may be good to put a special WARNING, about the danger of mistaking chest pain associated with a heart attack or other serious heart condition for gastrointestinal heartburn.

BSW-RMH (talk) 18:07, 18 May 2010 (UTC)

Diagnostic approach

An expanded summary of an Upper GI Series would be useful. BSW-RMH (talk) 19:35, 18 May 2010 (UTC)

Treatment

This section also requires expansion, again I recommend from the perspective that heartburn is being used to refer to chest pain being caused by gastric reflux. However, mention will need to be made of NERD which does not respond to PPI or other medication commonly used to treat GERD. Perhaps this is best presented a summary and linking to the more comprehensive article on GERD, however that article does not cover NERD or functional heartburn treatment options.

• Mayo Heartburn Treatment page (http://www.mayoclinic.com/health/heartburn-gerd/DS00095/DSECTION=treatments-and-drugs)
• Modlin et al. Diagnosis and Management of Non-erosive reflux disease-The Vevey NERD consensus group. Digestion (2009);80:74-88.
• Anderson, K. Gastroesophageal Reflux Disease. Radiol Technol (2010);81:251-268.
• Kushner PR. Curr Med Res Opin. Role of the primary care provider in the diagnosis and management of heartburn.

(2010);26(4):759-65. PMID: 20095795

BSW-RMH (talk) 19:35, 18 May 2010 (UTC)

It now covers function heartburn. More indepth treatment discussion belong on the subpages. NERD is a subtype of GERD and would be dealt with on that page.Doc James (talk · contribs · email) 19:58, 18 May 2010 (UTC)

I do not have access to the full text of PMID: 20095795 could you send me a copy? Thanks --Doc James (talk · contribs · email) 20:05, 18 May 2010 (UTC)

Yes, but I will have to scan it in so give me a little while-I only have access to the hard copy. I think you may want to read a bit more before making changes associated with these terms. NERD isn't a a subtype of GERD. And the concept of Functional heartburn (FH) is by no means a consensus in the GI field.

• Hershcovici T, Fass R. GERD: are functional heartburn and functional dyspepsia one disorder? Nat Rev Gastroenterol Hepatol. (2010);7(2):71-2. PMID: 20134484
• Modlin et al. Diagnosis and Management of Non-erosive reflux disease-The Vevey NERD consensus group. Digestion (2009);80:74-88.

BSW-RMH (talk) 20:38, 18 May 2010 (UTC)

References

Heart burn

Before we move forwards we must come to a conclusion regarding how we are going to use the term heartburn. This paper describes it as a typical symptom of an MI "other typical symptoms, including shortness of breath, nausea and vomiting, sweating, epigastric pain, abdominal pain or heartburn, and neck or shoulder pain (15%)" [6] Even though many source use it synonymously with GERD / gastritis this is not the case with the best sources. Doc James (talk · contribs · email) 17:10, 18 May 2010 (UTC)

There are always going to be primary research articles from individudal research groups using different terms different ways, sometimes in error, and not necessarily in reflection of clinical consensus-what we need to use as sources are references representing the majority consensus of a particular field, which may change and need to be updated over time. If possible, I would like to finish my review and then continue with discussion of this issue on my own time-or the review may not get finished. I will not make any direct edits during the review process and just post suggested re-writing here in consideration of your concerns. BSW-RMH (talk) 17:18, 18 May 2010 (UTC)

The is lots of evidence and plenty of reviews to support the assertion that heartburn is a symptoms that most commonly represents GERD but frequently represents ACS / MI. They teach this to everyone in medical school. A large portion of the general population realize that heartburn is a symptom of MI per "Given that one of the most powerful predictors of knowledge in our sample was sex, with women significantly more likely to have a score of at least 70% on the Knowledge Scale than men (odds ratio, 1.77; P < .001), we further examined differences between men and women in cardiac knowledge. Overall knowledge scores were higher for women than men (73% vs 70%). Women more accurately identified less-typical symptoms of AMI than men (back pain, jaw pain, heartburn, nausea, and neck pain)." from PMID 15877997. Sometimes the mayo clinic get it wrong. Doc James (talk · contribs · email) 17:25, 18 May 2010 (UTC)

By the way Uptodate has this too say in describing MI pain "Quality of the pain — The patient with myocardial ischemia often denies feeling chest "pain." More typical descriptions include squeezing, tightness, pressure, constriction, strangling, burning, heart burn, fullness in the chest, a band-like sensation, knot in the center of the chest, lump in the throat, ache, heavy weight on chest (elephant sitting on chest), like a bra too tight, and toothache (when there is radiation to the lower jaw)." [7] Doc James (talk · contribs · email) 17:29, 18 May 2010 (UTC)

I appreciate you are concerned about this topic but I keep losing edits because you are updating this page so frequently. Can we address this issue when the external review is finished? BSW-RMH (talk) 17:33, 18 May 2010 (UTC)

Doc James (talk · contribs · email) kindly moved this discussion to another page during the review process. It is reproduced here for further consdieration: BSW-RMH (talk) 20:15, 18 May 2010 (UTC)

Hi there, I've started copying to the clip board now :) I also try to hit preview often as this saves changes in a recoverable way too. OK, so I revised the edit to try to explain how I am approaching this. I am going to just use common terms here-to reflect the audience we are writing for. I appreciate fully your perspective and I've thought about this in detail. For me it comes down to writing for the Wikipedia audience. My recommendation for the definition is not to define heartburn as symptom but to define it as a symptom/condition/disease caused by acid backing up into the esophagus. The symptom you are calling heartburn I proposed to call a burning sensation in the chest. Here's my reasoning: that is the way the general public would most commonly define those two situations (as well as gastroenterologists). I do recognize that some lay people, and emergency docs as you mentioned, also use 'heartburn' to refer to any burning sensation in the chest AND that these different causes of burning sensations in the chest can be easily confused by patients if the pain is not severe, which should be noted in the definition section, but I don't think that is the most common definition. I think this makes the most sense, and is the most in line with the purpose of Wikipedia. I'll leave the recommendation on the talk page though so editors can hash it out and reach consensus on whether to define it as a 'symptom' or a 'symptom/conditon/disease'. BSW-RMH (talk) 18:43, 18 May 2010 (UTC)

Wikipedia has a policy to deal with naming issues for medical articles Wikipedia:Manual of Style (medicine-related articles) which stipulates that we us technical terms in a technical sense. Gastroenterologist BTW do not usually use the term "heartburn" to describe a disease but the more specific terms GERD, functional heartburn, etc. I agree that the lay press does use heartburn to indicate GERD but we cannot us it in this sense as 1) we already have a page on this topic so this would be a cotract 2) it would become to complicated we a mix of technical and nontechnical terms.Doc James (talk · contribs · email) 19:21, 18 May 2010 (UTC)

I also agree that scientific intitutions such as the mayo clinic when writing for the lay public use heartburn as a synonym for GERD. I think this is poor practice but it is what it is.Doc James (talk · contribs · email) 19:23, 18 May 2010 (UTC)

Let me be clear: I am not using or recommending using GERD as synonymous with gastric reflux. GI clinicians commonly use heartburn to refer to the pain caused by gastric reflux in general, not just GERD. GERD is a very specific disease/condition/disorder and rightly should have it's own article. Any gastroenterologists out there that can weight on this discussion?-I'll try to locate one to get on here. Meanwhile here's a list of publications supporting this terminology in common use by clinicians.BSW-RMH (talk) 20:10, 18 May 2010 (UTC)

• Fass R, Sifrim D. Management of heartburn not responding to proton pump inhibitors. Gut. 2009 Feb;58(2):295-309.PMID 19136523
• Dowswell T, Neilson JP. Interventions for heartburn in pregnancy. Cochrane Database Syst Rev. 2008 Oct 8;(4):CD007065.PMID: 18843742
• Ang D, Sifrim D, Tack J.Mechanisms of heartburn. Nat Clin Pract Gastroenterol Hepatol. 2008 Jul;5(7):383-92. PMID: 18542113

BSW-RMH (talk) 20:22, 18 May 2010 (UTC)

Yes all the above are good references. The Cochrane review describes it as a symptoms and I think that is were we should start. I assume we can all agree that it is a symptom? Symptoms than lead to a differential diagnosis.Doc James (talk · contribs · email) 21:57, 18 May 2010 (UTC)

A symptom specifically referring the burning chest pain caused by acid reflux? :) Then yes, I agree. BSW-RMH (talk) 22:04, 18 May 2010 (UTC)

Than what would we call burning chest pain not caused by acid reflux?Doc James (talk · contribs · email) 22:08, 18 May 2010 (UTC)

'burning chest pain' BSW-RMH (talk) 22:12, 18 May 2010 (UTC)

Other cause of heartburn

A few other cause of heartburn include function heartburn. Per uptodate "it is highly likely that functional heartburn represents a heterogeneous group of patients with different physiological mechanisms for their symptoms." ie not acid reflux related.Doc James (talk · contribs · email) 18:22, 18 May 2010 (UTC)

Functional heartburn (FH) refers to heartburn that does not respod to PPI or other heartburn-prevention medications. It is still not clear if FH represents a distinct condition were gastric reflux does not occur, or if it is just misdiagnosed NERD (heartburn caused by gastric reflux but without the esophageal erosion characteristic of GERD). BSW-RMH (talk) 18:52, 18 May 2010 (UTC)

It says that the cause is unknown which means that reflux has been ruled out. It is more than just heartburn that has not responded to PPIs even though it is the most common cause of non response. Thus one cannot say it is due to reflux. Here is the text from the 09 review.

As a group, functional esophageal disorders are characterized by the presence of chronic symptoms attributed to the esophagus without evidence of structural or metabolic disorder. According to the Rome III criteria, patients should experience functional esophageal disorders for at least 3 months with symptom onset at least 6 months before diagnosis (Box 1).^[4] Nonesophageal sources for symptoms should be excluded first before esophageal causes are entertained. Gastroesophageal reflux disease (GERD) and various esophageal motility disorders may be responsible for the spectrum of functional esophageal-related symptoms. Hence, it is imperative that these conditions be ruled out before a diagnosis of a functional esophageal disorder is established. Rome III also removed rumination syndrome from the functional esophageal disorder group and added it to the functional gastroduodenal disorders. Although the Rome project attempts to repeatedly update the diagnostic criteria of the different functional bowel disorders, the relatively high frequency (approximately every 5 years) of the meetings that are commonly associated with changes in diagnostic criteria may render past and ongoing studies in this field obsolete.

Doc James (talk · contribs · email) 19:10, 18 May 2010 (UTC)

This is all correct information. Let me try to clear this up. Heartburn (as I am recommending defining it and as it is used in the references we are discussing) is caused by acid backing up into the esophagus: this results from metabolic or functional disorders (GERD, NERD, etc.), OR from dyspepsia (upset stomach). Functional heartburn is a newer term that is still in debate as to whether it exists as a distinct disorder (right now it is classification of symptoms and negative diagnostic tests) or is misdiagnosed NERD (the reference you provided is the best evidence that it is not NERD) or misdiagnosed dyspepsia (the reference you provided does not control for this, see discussion in: Hershcovici T, Fass R. GERD: are functional heartburn and functional dyspepsia one disorder? Nat Rev Gastroenterol Hepatol. (2010);7(2):71-2. PMID: 20134484). Considering there is not yet a consensus in the field on the etiology of FH, I don't think we should include it yet. BSW-RMH (talk) 20:07, 18 May 2010 (UTC)

Neither gastitis, functional heartburn or myocardial ischemia are cause by acid backing up. GERD and NERD are yes but they are not functional disorders per the ROME 111 criteria. But let see what others think.Doc James (talk · contribs · email) 21:50, 18 May 2010 (UTC)

Yes, please-more input needed-no progress can be made until a consensus is reached. BSW-RMH (talk) 22:11, 18 May 2010 (UTC)

As a medically-trained professional, I consider heartburn to be a syndrome, one cause of which is GERD; therefore, I endorse the sense of "heartburn" as a symptom caused by a constellation of mechanisms. As a person who searches WP for topics on which I'm not an expert, I would expect a commonly-used term to have a page that represents common usage, hence I again endorse a broad treatment of a term that is commonly used for a wide variety of ailments. -- Scray (talk) 02:30, 19 May 2010 (UTC)

The question

The question is should heart burn mean "burning in ones chest from any cause" or "burning in ones chest from acid reflux".Doc James (talk · contribs · email) 03:13, 19 May 2010 (UTC)

I don't know much about heartburn, but I'm tentatively with Scray: I think that 'any cause' is appropriate and likely to be what our readers expect to find on this page. Acid reflux might be the most important cause (and therefore should dominate the page), but I wouldn't want to exclude at least a brief mention of other causes. WhatamIdoing (talk) 03:38, 23 May 2010 (UTC)

Just a note: the article is currently written as 'heartburn the disease'-other causes of similar burning chest pain that can sometimes be mistaken for acid reflux (such as heart attack) are mentioned as sharing the symptom of burning chest pain. DocJames would like it rewritten as heartburn being a symptom of many diseases, rather than a disease itself. Perhaps there needs to be a disambiguation page for heartburn(disease) vs. heartburn(symptom)?BSW-RMH (talk) 14:43, 23 May 2010 (UTC)

I am not convinced that heartburn is a disease. It is a symptoms yes. Diseases would include GERD, gastritis etc. It is currently written as a symptom per WP:MEDMOS. Further evidence to support my position include the ICD10 criteria [8] here which describes heart burn as a "Symptoms and signs involving the digestive system and abdomen" and not as a disease. Doc James (talk · contribs · email)

18:40, 23 May 2010 (UTC)

I agree with the perspectives of Scray and WhatamIdoing, which I will attempt to summarize here. It appears that the consensus is that most people will come to the page either looking for information on heartburn as a 'syndrome or condition' caused by gastric/acid reflux, a common meaning, OR information on the symptom of heartburn/burning chest pain. Thus the article should be written to cover all meanings, with a focus on the heartburn 'syndrome/condition' caused by gastric/acid reflux (GERD or indigestion etc.) being the most common cause of heartburn/burning chest pain. It appears that we now have three editors (BSW-RMH, Scray, WhatamIdoing) that support this consensus. Any clarifications? DocJames, how does this sound to you? It would great to move forward with the needed changes to get this article to GA status, because it is a high priority article. BSW-RMH (talk) 17:27, 26 May 2010 (UTC)

About 42% of the United States population have had heartburn at some point.

So what?

--178.108.246.141 (talk) 23:05, 30 March 2011 (UTC)

Statistics for other areas of the world would be helpful, if this section is not going to be deleted. 03jkeeley (talk) 14:01, 26 August 2013 (UTC)

Heartburn and dyspepsia

Or basically the same. Thus propose a merge. Doc James (talk · contribs · email) 23:59, 23 February 2015 (UTC)

Indigestion is wider term. Therefore remove this proposal. Doc James (talk · contribs · email) 09:17, 21 June 2015 (UTC)

Not that I'm contributing anything here, but dyspepsia is abdominal pain and heartburn chest discomfort. The equivalent classic term for heartburn would be pyrosis -- Samir 05:43, 7 October 2015 (UTC)

"Agita" listed at Redirects for discussion

The redirect Agita has been listed at redirects for discussion to determine whether its use and function meets the redirect guidelines. Readers of this page are welcome to comment on this redirect at Wikipedia:Redirects for discussion/Log/2023 May 28 § Agita until a consensus is reached. WPscatter ^t/_c 20:35, 28 May 2023 (UTC)

Wiki Education assignment: PHMD 2040 Service - Learning Fall 2023

This article was the subject of a Wiki Education Foundation-supported course assignment, between 31 May 2023 and 29 December 2023. Further details are available on the course page. Student editor(s): PharmD2026 (article contribs).

— Assignment last updated by PharmD2026 (talk) 03:38, 14 April 2024 (UTC)

Hello,

I will be adding sources to a few areas that have [citation needed] and also some behavioral/lifestyle modifications --PharmD2026 (talk) 20:10, 14 April 2024 (UTC)