|
Headlines:
|
 |
Heartburn
Definition
It is a sensation of discomfort due to indigestion. It is usually witnessed
as a retrosternal acute burning sensation.
A. Heartburn in immunocompetent individuals
GERD
Heartburn is a cardinal symptom of
GERD (gastro-esophageal reflux disease) &
is relatively specific; because of the safety of most antireflux medications,
an empirical approach is appropriate for many patients with
GERD.
However, the presence of certain symptoms or signs in a patient with
reflux-like symptoms should lead to an early endoscopy:
- dysphagia or
odynophagia
- weight loss
- gastrointestinal bleeding
- frequent vomiting
These symptoms imply either the development of a
GERD-related complication
(e.g., stricture, Barrett's esophagus, or
adenocarcinoma) or another disorder
masquerading as GERD (e.g.,
squamous cell cancer or a gastric/duodenal lesion
such as cancer or
peptic ulcer).
B. Heartburn in immunocompromised patients
Heartburn in immunocompromised patients often indicates an esophageal
infection.
- Candida
- cytomegalovirus
- herpesvirus
- idiopathic esophageal ulcers
Because most patients with the acquired immunodeficiency syndrome and
esophagitis will have candidiasis, an empirical 1- to 2-week course of antifungal
therapy may be justified. Those who fail this approach, however, should
almost always have an endoscopy and biopsy because each of the common causes
requires specific therapy.
|
|
|
|
Are you a doctor or a nurse?
Do you want to join the Doctors Lounge online medical community?
Participate in editorial activities (publish, peer review, edit) and
give a helping hand to the largest online community of patients.
Click on the link below to see the requirements:
Doctors Lounge Membership
Application |
|
|
send
to a friend
printer
friendly version
