Paper
Dyspepsia and heartburn: a clinical challenge
Published Dec 1, 1997 · N. J. Talley
Alimentary Pharmacology & Therapeutics
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Abstract
In recent years it has been widely accepted that the symptom patterns of dyspepsia should be distinguished from heartburn. Dyspepsia is now defined as pain or discomfort centred in the upper abdomen while heartburn is a burning retrosternal pain or discomfort. Both of these symptoms can, of course, be present in a single patient. In the general population, the annual prevalences of recurrent dyspepsia and heartburn (more than once a month) are approximately 25% and 15%, respectively, in Western nations. When these standard definitions are applied the prevalences of these symptoms differ only modestly from country to country. Gastro‐oesophageal reflux disease probably accounts for approximately 25% of patients with dyspepsia, based on endoscopy and 24‐hour pH monitoring results. The prevalence of dyspepsia and heartburn in the population remains stable from year to year. Symptoms disappear in approximately 30% of patients each year but this is balanced by the onset of symptoms in others. It has not proved clinically useful to subdivide dyspepsia into symptom subgroups based on expert opinion. Medical advice is sought by only a minority of patients with dyspepsia or heartburn and, while psychological factors and to a lesser extent symptom severity are important, there is little information on the reasons why advice is sought. The economic impact of dyspepsia and heartburn is substantial because of the high prevalence of these symptoms. Despite the importance of dyspepsia and heartburn in the population, their long‐term natural history remains inadequately described.
Dyspepsia and heartburn have high prevalence in the population, but their long-term natural history remains inadequately described, with a significant economic impact.
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