ABSTRACT
Gastroesophageal reflux disease (GERD) is a condition which develops when the reflux of stomach contents causes troublesome symptoms and/or complications. Heartburn and regurgitation are the typical symptoms of GERD. The treatment of GERD encompasses lifestyle modifications, pharmacological, endoscopic, and surgical therapy. The majority of the patients respond to 4-8 weeks of proton-pump inhibitors therapy, but 20-42% will demonstrate partial or complete lack of response to treatment. While these patients have been considered as having refractory heartburn, a subset of them does not have GERD or have not been adequately treated. The main causes of refractory heartburn include: poor compliance; inadequate proton-pump inhibitors dosage; incorrect diagnosis; comorbidities; genotypic differences; residual gastroesophageal reflux; eosinophilic esophagitis and others. Treatment is commonly directed toward the underlying cause of patients' refractory heartburn.
Subject(s)
Gastroesophageal Reflux/therapy , Heartburn/therapy , Gastroesophageal Reflux/diagnosis , Gastroesophageal Reflux/etiology , Heartburn/diagnosis , Heartburn/etiology , Humans , Life Style , Patient Compliance , Proton Pump Inhibitors/therapeutic use , RecurrenceABSTRACT
INTRODUCTION: Heartburn is a common complaint during pregnancy; the incidence is reported to be between 17% and 45%. METHODS AND OUTCOMES: We conducted a systematic overview and aimed to answer the following clinical question: What are the effects of interventions to prevent or treat heartburn in pregnancy? We searched Medline, Embase, The Cochrane Library, and other important databases up to December 2014 (Clinical Evidence reviews are updated periodically; please check our website for the most up-to-date version of this review). RESULTS: At this update, searching of electronic databases retrieved 80 studies. After deduplication and removal of conference abstracts, 59 records were screened for inclusion in the review. Appraisal of titles and abstracts led to the exclusion of 58 studies and the further review of one full publication. The full article evaluated did not meet our reporting criteria, and thus no new evidence was added at this update. We performed a GRADE evaluation for two PICO combinations. CONCLUSIONS: In this systematic overview, we categorised the efficacy for six interventions, based on information about the effectiveness and safety of acid-suppressing drugs, antacids with or without alginates, raising the head of the bed, reducing caffeine intake, reducing intake of fatty foods, and reducing the size and frequency of meals.
Subject(s)
Heartburn/therapy , Pregnancy Complications/therapy , Antacids/therapeutic use , Beds , Diet , Female , Heartburn/drug therapy , Humans , Pregnancy , Pregnancy Complications/drug therapyABSTRACT
"Were are what we eat" - so the old adage goes, so maybe it is not surprising that many people have problems with their digestive system. These problems can vary from a bit of indigestion accasionally, to serious and incapacitating inflammatory bowel disease.