626:
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. In young persons (typically <40 years) who present with heartburn symptoms consistent with GERD (onset after eating, when lying down, when pregnant), a physician may begin a course of PPIs to assess clinical improvement before additional testing is undergone. Resolution or improvement of symptoms on this course may result in a diagnosis of GERD.
706:: the esophageal mucosa can be visualized directly by passing a thin, lighted tube with a tiny camera known as an endoscope attached through the mouth to examine the oesophagus and stomach. In this way, evidence of esophageal inflammation can be detected, and biopsies taken if necessary. Since an endoscopy allows a doctor to visually inspect the upper digestive tract the procedure may help identify any additional damage to the tract that may not have been detected otherwise.
684:
in the lower esophagus. Because some degree of variation in acidity is normal, and small reflux events are relatively common, esophageal pH monitoring can be used to document reflux in real-time. Patients are able to record symptom onset to correlate lower esophageal pH with time of symptom onset.
250:
The cause will vary depending on one's family and medical history, genetics, if a person is pregnant or lactating, and age. As a result, the diagnosis will vary depending on the suspected organ and the inciting disease process. Work-up will vary depending on the clinical suspicion of the provider
246:
Other common descriptors for heartburn (besides burning) are belching, nausea, squeezing, stabbing, or a sensation of pressure on the chest. The pain often rises in the chest (directly behind the breastbone) and may radiate to the neck, throat, or angle of the arm. Because the chest houses other
625:
Heartburn can be caused by several conditions and a preliminary diagnosis of GERD is based on additional signs and symptoms. The chest pain caused by GERD 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
335:
for chest pain have findings that do not account for their chest discomfort. These are often defined as having "atypical chest pain" or chest pain of undetermined origin. Women experiencing heart attacks may also deny classic signs and symptoms and instead complain of GI symptoms. One article
310:
Heartburn-like symptoms and/or lower chest or upper abdomen may be indicative of much more sinister and/or deadly disease. Of greatest concern is to confuse heartburn (generally related to the esophagus) with a heart attack as these organs share a common
813:
Symptoms of heartburn may not always be the result of an organic cause. Patients may respond better to therapies targeting anxiety, through medications aimed towards a psychiatric etiology, osteopathic manipulation, and acupuncture.
2962:
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669:
increases the suspicion that the pain is esophageal in origin. This however does not rule out a potential cardiac cause as 10% of cases of discomfort due to cardiac causes are improved with antacids.
2307:
925:
900:
2111:
Dickman R, Schiff E, Holland A, Wright C, Sarela SR, Han B, et al. (November 2007). "Clinical trial: acupuncture vs. doubling the proton pump inhibitor dose in refractory heartburn".
179:
consumption. Decrease peppermint consumption. Chew foods thoroughly between bites, consume meals with plenty of liquid, and ensure adequate time to eat meals in a non-hurried fashion
2300:
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supply. Numerous abdominal and thoracic organs are present in that region of the body. Many different organ systems might explain the discomfort called heartburn.
561:
Functional heartburn is heartburn of unknown cause. It is commonly associated with psychiatric conditions like depression and anxiety. It is also seen with other
573:(PPIs). Despite this, PPIs are still the primary treatment with response rates in about 50% of people. The diagnosis is one of elimination, based upon the
1479:
892:
1930:
Johnson LF, Demeester TR (October 1974). "Twenty-four-hour pH monitoring of the distal esophagus. A quantitative measure of gastroesophageal reflux".
720:
Treatment plans are tailored to the specific diagnosis and etiology of the heartburn. Management of heartburn can be sorted into various categories.
1008:
2062:"Fiber-enriched diet helps to control symptoms and improves esophageal motility in patients with non-erosive gastroesophageal reflux disease"
870:
377:– tears of the superficial mucosa of the esophagus that are subsequently exposed to gastric acid commonly due to vomiting and/or retching
2008:
1815:
247:
important organs besides the esophagus (including the heart and lungs), not all symptoms related to heartburn are esophageal in nature.
1082:
1728:
712:: a small sample of tissue from the oesophagus is removed. It is then studied to check for inflammation, cancer, or other problems.
801:
Weight loss can decrease abdominal pressure that both delays gastric emptying and increases gastric acid reflux into the esophagus
1096:
Delaney B, Ford AC, Forman D, Moayyedi P, Qume M (October 2005). Delaney B (ed.). "Initial management strategies for dyspepsia".
1750:
1339:
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Psychotherapy may show a positive role in treatment of heartburn and the reduction of distress experienced during symptoms.
271:
2285:
1770:
Domingues G, Moraes-Filho JP, Fass R (March 2018). "Refractory
Heartburn: A Challenging Problem in Clinical Practice".
526:
having been reported in as many as 80% of pregnancies. It is most often due to GERD and results from relaxation of the
1076:
837:
may be required if PPI is not effective. Surgery is not undergone if functional heartburn is the leading diagnosis.
171:
Avoid foods that are high in fats, spicy, high in artificial flavors. Avoid reclining 3–4 hours after a meal, heavy
1858:"Value and limitations of chest pain history in the evaluation of patients with suspected acute coronary syndromes"
2203:
Fass R, Zerbib F, Gyawali CP (June 2020). "AGA Clinical
Practice Update on Functional Heartburn: Expert Review".
349:
299:
240:
98:
1399:
Patel H, Rosengren A, Ekman I (July 2004). "Symptoms in acute coronary syndromes: does sex make a difference?".
552:
Behavioral – as with other instances of heartburn, behavioral modifications can exacerbate or alleviate symptoms
2528:
1476:
1364:
Waller CG (December 2006). "Understanding prehospital delay behavior in acute myocardial infarction in women".
294:
includes heartburn along with a number of other symptoms. Indigestion is sometimes defined as a combination of
1434:
Kawamoto KR, Davis MB, Duvernoy CS (December 2016). "Acute
Coronary Syndromes: Differences in Men and Women".
534:, and/or increasing intra-abdominal pressure. The onset of symptoms can be during any trimester of pregnancy.
643:
612:
1292:"Sex Differences in Symptom Presentation in Acute Coronary Syndromes: A Systematic Review and Meta-analysis"
2246:
Kushner PR (April 2010). "Role of the primary care provider in the diagnosis and management of heartburn".
798:
Early studies show that diets that are high in fiber may show evidence in decreasing symptoms of dyspepsia.
397:– related to the intake of caustic substances, excessive amounts of hot liquids, alcohol, or tobacco smoke
401:
27:
1190:
Bautz B, Schneider JI (May 2020). "High-Risk Chief
Complaints I: Chest Pain-The Big Three (an Update)".
1000:
636:
Endoscopy looking for erosive changes of the esophagus consistent with prolonged acid exposure (e.g. -
374:
20:
633:
Onset of symptoms after eating or drinking, at night, and/or with pregnancy, and improvement with PPIs
549:
Mechanical – the enlarging uterus increasing intra-abdominal pressure, inducing reflux of gastric acid
2913:
1960:
527:
121:
2977:
2822:
824:– in cases of PPI failure, adding acupuncture may be more effective than doubling the dose of PPIs.
677:
566:
380:
251:
seeing the patient, but generally includes endoscopy and a trial of antacids to assess for relief.
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2448:
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332:
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infection or heavy NSAID use that weakens stomach mucosal layer. Pain often worsens with eating.
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747:
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450:
405:
337:
128:
3006:
1906:
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2800:
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2553:
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2000:
834:
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324:
1835:. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins. 2008. p. 213.
1066:
949:. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins. 2008. p. 211.
700:) is passed via the mouth into the esophagus and measures the pressure of the LES directly.
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2394:
693:
418:
364:
153:
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2154:
Spechler SJ, Hunter JG, Jones KM, Lee R, Smith BR, Mashimo H, et al. (October 2019).
1725:
361:– typically occur after eating or drinking and may be combined with difficulty swallowing.
8:
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863:"Pyrosis definition - MedicineNet - Health and Medical Information Produced by Doctors"
788:
Avoiding reclining 2.5–3.5 hours after a meal to prevent the reflux of stomach contents
737:
510:
161:
78:
71:
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1238:"Prevalence of linked angina and gastroesophageal reflux disease in general practice"
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893:"Gastroesophageal Reflux (GER) and Gastroesophageal Reflux Disease (GERD) in Adults"
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63:
1574:
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1290:
van
Oosterhout RE, de Boer AR, Maas AH, Rutten FH, Bots ML, Peters SA (May 2020).
352:(most common cause of heartburn) – occurs when acid refluxes from the stomach and
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1483:
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493:
460:
295:
275:
67:
2156:"Randomized Trial of Medical versus Surgical Treatment for Refractory Heartburn"
2858:
2848:
2790:
2725:
2639:
1701:
1688:
Fass R (January 2009). "Functional heartburn: what it is and how to treat it".
1531:
Oustamanolakis P, Tack J (March 2012). "Dyspepsia: organic versus functional".
1033:
680:: a probe can be placed via the nose into the esophagus to record the level of
430:
176:
2259:
1813:
National
Digestive Diseases Information Clearinghouse (NDDIC): Upper GI Series
1783:
1447:
1412:
1203:
26:"Cardialgia" redirects here. For the meaning "pain in or near the heart", see
3022:
2863:
2644:
2538:
2518:
2078:
1874:
1857:
1601:
Richter JE (March 2003). "Gastroesophageal reflux disease during pregnancy".
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Other tests or symptoms suggesting acid reflux is causing heartburn include:
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About 42% of the United States population has had heartburn at some point.
776:
574:
543:
485:
232:
137:
2172:
2155:
1943:
1497:
1136:. If this is an intentional citation to a retracted paper, please replace
3001:
2893:
2770:
2401:
821:
656:
353:
302:(GERD) rather than just to describe a symptom of burning in one's chest.
291:
228:
105:
1663:
1254:
782:
Avoiding chocolate, peppermint, caffeine intake, and foods high in fats
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2654:
2586:
2577:
2569:
2559:
2411:
2406:
2372:
2357:
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Relief of symptoms 5 to 10 minutes after the administration of viscous
489:
456:
328:
279:
255:
195:
31:
2939:
1636:
Van Thiel DH, Gavaler JS, Joshi SN, Sara RK, Stremple J (April 1977).
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751:
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662:
523:
473:
267:
236:
141:
897:
The
National Institute of Diabetes and Digestive and Kidney Diseases
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and is the primary cause of lack of improvement post treatment with
262:. Dietary changes may require avoiding foods that are high in fats,
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2611:
2347:
539:
263:
259:
200:
187:
88:
1955:
1953:
785:
Limiting big meals, instead consuming smaller, more frequent meals
577:. It was found to be present in 22.3% of Canadians in one survey.
120:
Physical examination, medical history, antacid response, imaging,
2697:
2692:
2421:
2324:
971:"Pyrosis Medical Definition - Merriam-Webster Medical Dictionary"
729:
681:
666:
282:
consumption. Lifestyle changes may help such as reducing weight.
19:
This article is about the medical condition. For other uses, see
750:
are effective for the two most common causes of heartburn (e.g.
2951:
2814:
2342:
1987:
British
Medical Association Complete Family Health Encyclopedia
1950:
1289:
709:
298:
and heartburn. Heartburn is commonly used interchangeably with
224:
157:
133:
84:
1236:
Kato H, Ishii T, Akimoto T, Urita Y, Sugimoto M (April 2009).
775:
Taking medications 30–45 minutes before eating suppresses the
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2498:
384:
312:
172:
16:
Burning sensation mainly due to gastric acid in the esophagus
755:
2110:
808:
1769:
1635:
1095:
1502:(Tenth ed.). Philadelphia, Pennsylvania: Elsevier.
83:
Burning, stabbing, or squeezing sensation in the chest,
2059:
2036:
2153:
1495:
1164:
1575:"Pernicious anemia: MedlinePlus Medical Encyclopedia"
1433:
1235:
2929:
1690:
Gastrointestinal
Endoscopy Clinics of North America
1398:
1031:
1898:
1596:
1594:
1530:
603:Elimination of heart attack and GERD as the cause
445:– generally secondary to other conditions such as
2202:
3029:Symptoms and signs: Digestive system and abdomen
3020:
1929:
1496:Kumar V, Abbas AK, Aster JC, Perkins JA (2018).
833:In the case of GERD causing heartburn symptoms,
740:) are often taken to treat the immediate problem
538:Hormonal – related to the increasing amounts of
331:. However, as many as 30% of people who receive
2060:Morozov S, Isakov V, Konovalova M (June 2018).
1591:
1040:. Treasure Island (FL): StatPearls Publishing.
231:. Heartburn is usually due to regurgitation of
1905:. Baltimore: Williams & Wilkins. pp.
1189:
2301:
1901:Principles and practice of emergency medicine
1896:
2034:
1855:
1231:
1229:
941:
939:
1192:Emergency Medicine Clinics of North America
1098:The Cochrane Database of Systematic Reviews
723:
383:– a disease commonly associated with other
2308:
2294:
2113:Alimentary Pharmacology & Therapeutics
1743:
1741:
1150:|...|intentional=yes}}
792:
463:. May be the result of several conditions.
408:, most common in immunocompromised persons
2171:
2087:
2077:
1873:
1653:
1603:Gastroenterology Clinics of North America
1315:
1296:Journal of the American Heart Association
1263:
1253:
1226:
936:
340:may appear to be GERD in 0.6% of people.
305:
1932:The American Journal of Gastroenterology
1165:Sajatovic, Loue S, Koroukian SM (2008).
769:
258:and dietary changes. Medication include
223:, is a burning sensation in the central
2245:
1738:
1721:
1719:
1683:
1681:
1679:
1677:
1675:
1673:
1600:
1167:Encyclopedia of aging and public health
1064:
809:Alternative and complementary therapies
646:looking for the presence of acid reflux
3021:
2041:Canadian Pharmacists Association (CPS)
1856:Swap CJ, Nagurney JT (November 2005).
1833:Differential diagnosis in primary care
1363:
947:Differential diagnosis in primary care
828:
620:
2289:
2030:
2028:
2026:
1765:
1763:
1285:
1283:
563:functional gastrointestinal disorders
492:, due to a gallstone obstructing the
2248:Current Medical Research and Opinion
1965:The Lecturio Medical Concept Library
1716:
1687:
1670:
1533:Journal of Clinical Gastroenterology
1027:
1025:
921:
919:
917:
873:from the original on 23 January 2014
400:Infectious esophagitis – especially
254:Treatment for heartburn may include
2160:The New England Journal of Medicine
1989:. Dorling Kindersley Limited. 1990.
696:: in this test, a pressure sensor (
13:
2035:Q.D. Pham Co (September 1, 2018).
2023:
1760:
1378:10.1097/01.hpc.0000249621.40659.cf
1280:
1032:Johnson K, Ghassemzadeh S (2024).
453:. Pain often improves with eating.
14:
3040:
2066:World Journal of Gastroenterology
2011:from the original on 2 March 2017
1961:"Gastroesophageal Reflux Disease"
1242:World Journal of Gastroenterology
1169:. Berlin: Springer. p. 419.
1071:. New York: Springer. p. 2.
1022:
981:from the original on 25 July 2015
914:
556:
496:, related to alcohol consumption.
2125:10.1111/j.1365-2036.2007.03520.x
1085:from the original on 2015-06-21.
595:Burning retrosternal discomfort
528:lower esophageal sphincter (LES)
387:such as asthma, food allergies,
2239:
2196:
2147:
2104:
2053:
1993:
1978:
1923:
1890:
1849:
1825:
1806:
1772:Digestive Diseases and Sciences
1629:
1567:
1524:
1489:
1470:
1436:Current Atherosclerosis Reports
1427:
1392:
1366:Critical Pathways in Cardiology
1357:
1332:
1183:
1158:
1011:from the original on 2016-03-12
903:from the original on 2015-07-25
840:
300:gastroesophageal reflux disease
241:gastroesophageal reflux disease
99:Gastroesophageal reflux disease
1897:Hanke BK, Schwartz GR (1999).
1748:The MedlinePlus Heartburn page
1726:The Mayo Clinic Heartburn page
1477:MedlinePlus: Esophageal spasms
1125:10.1002/14651858.CD001961.pub3
1106:10.1002/14651858.CD001961.pub2
1089:
1068:Dyspepsia in clinical practice
1058:
993:
963:
885:
855:
672:
650:
467:
323:The most common symptom for a
1:
1655:10.1016/S0016-5085(77)80151-0
1615:10.1016/s0889-8553(02)00065-1
1340:"Heartburn and Regurgitation"
848:
688:
613:esophageal motility disorders
500:
436:
285:
239:. It is the major symptom of
2217:10.1053/j.gastro.2020.01.034
2001:"What Are Antacids? - TUMS®"
1545:10.1097/MCG.0b013e318241b335
1005:National Library of Medicine
931:Dorland's Medical Dictionary
715:
517:
509:– can be autoimmune, due to
449:infection or cancers of the
343:
278:consumption, and decreasing
7:
2529:Charcot's cholangitis triad
546:and their effect on the LES
522:Heartburn is common during
479:
10:
3045:
1702:10.1016/j.giec.2008.12.002
654:
412:
235:(gastric reflux) into the
25:
21:Heartburn (disambiguation)
18:
2992:
2933:
2914:Sister Mary Joseph nodule
2836:
2813:
2751:
2718:
2675:
2632:
2625:
2568:
2490:
2331:
2260:10.1185/03007990903553812
1784:10.1007/s10620-018-4927-5
1448:10.1007/s11883-016-0629-7
1413:10.1016/j.ahj.2004.03.005
1204:10.1016/j.emc.2020.01.009
777:stomach's acid generating
406:certain fungal infections
391:, and atopic skin disease
194:
183:
167:
127:
114:
104:
94:
77:
57:
49:
44:
2079:10.3748/wjg.v24.i21.2291
1875:10.1001/jama.294.20.2623
1638:"Heartburn of pregnancy"
1486:Accessed April 18, 2010.
761:Antibiotics are used if
724:Pharmacologic management
678:Esophageal pH monitoring
567:irritable bowel syndrome
381:Eosinophilic esophagitis
318:
1735:.Accessed May 18, 2010.
1499:Robbins basic pathology
1308:10.1161/JAHA.119.014733
1065:Duvnjak M, ed. (2011).
793:Lifestyle modifications
744:H2 receptor antagonists
354:inflames the esophagus.
333:cardiac catheterization
2321:human digestive system
1822:Accessed May 18, 2010.
1757:Accessed May 18, 2010.
1401:American Heart Journal
748:proton pump inhibitors
571:proton pump inhibitors
459:– inflammation of the
451:gastrointestinal tract
421:– can be secondary to
338:ischemic heart disease
306:Differential diagnosis
190:, weight loss, surgery
129:Differential diagnosis
2607:Obstructed defecation
2173:10.1056/NEJMoa1811424
1142:|...}}
1119:(Retracted, see
770:Behavioral management
365:Esophageal strictures
229:upper central abdomen
154:esophageal strictures
2869:Aure-Rozanova's sign
2828:Hannington-Kiff sign
2823:Howship–Romberg sign
2781:Aortic insufficiency
2683:Abdominal distension
2037:"Dyspepsia and GERD"
419:Peptic ulcer disease
395:Chemical esophagitis
274:use, avoiding heavy
146:peptic ulcer disease
2434:Chilaiditi syndrome
1648:(4 Pt 1): 666–668.
1255:10.3748/wjg.15.1764
975:merriam-webster.com
829:Surgical management
638:Barrett's esophagus
621:Diagnostic approach
581:
424:Helicobacter pylori
270:, heavily reducing
53:Pyrosis, cardialgia
2993:External resources
2801:Grey Turner's sign
2731:Hepatosplenomegaly
2660:Abdominal guarding
2592:Fecal occult blood
2583:Fecal incontinence
2554:Mirizzi's syndrome
2464:Sherren's triangle
2317:Signs and symptoms
1818:2010-05-27 at the
1753:2016-04-25 at the
1731:2010-05-23 at the
1482:2010-05-17 at the
738:sodium bicarbonate
587:Rome III Criteria
580:
511:atrophic gastritis
389:seasonal allergies
375:Mallory-Weis tears
370:Esophageal cancers
268:artificial flavors
72:emergency medicine
3016:
3015:
2927:
2926:
2899:Fothergill's sign
2889:Rosenstein's sign
2809:
2808:
2764:Mallet-Guy's sign
2703:Shifting dullness
2524:Courvoisier's law
2166:(16): 1513–1523.
2119:(10): 1333–1344.
2072:(21): 2291–2299.
2005:www.heartburn.com
1916:978-0-683-07646-2
1868:(20): 2623–2629.
1842:978-0-7817-6812-2
1509:978-0-323-35317-5
1248:(14): 1764–1768.
1176:978-0-387-33753-1
956:978-0-7817-6812-2
804:Smoking cessation
734:calcium carbonate
618:
617:
575:Rome III criteria
507:Pernicious anemia
443:Intestinal ulcers
359:Esophageal spasms
206:
205:
150:esophageal spasms
116:Diagnostic method
39:Medical condition
3036:
2931:
2930:
2630:
2629:
2617:Rectal discharge
2533:Reynolds' pentad
2472:Radiologic signs
2459:McBurney's point
2333:Gastrointestinal
2319:relating to the
2310:
2303:
2296:
2287:
2286:
2280:
2279:
2243:
2237:
2236:
2211:(8): 2286–2293.
2205:Gastroenterology
2200:
2194:
2193:
2175:
2151:
2145:
2144:
2108:
2102:
2101:
2091:
2081:
2057:
2051:
2050:
2048:
2047:
2032:
2021:
2020:
2018:
2016:
1997:
1991:
1990:
1982:
1976:
1975:
1973:
1971:
1957:
1948:
1947:
1927:
1921:
1920:
1904:
1894:
1888:
1887:
1877:
1853:
1847:
1846:
1829:
1823:
1810:
1804:
1803:
1767:
1758:
1745:
1736:
1723:
1714:
1713:
1685:
1668:
1667:
1657:
1642:Gastroenterology
1633:
1627:
1626:
1598:
1589:
1588:
1586:
1585:
1571:
1565:
1564:
1528:
1522:
1521:
1493:
1487:
1474:
1468:
1467:
1431:
1425:
1424:
1396:
1390:
1389:
1361:
1355:
1354:
1352:
1351:
1342:. Archived from
1336:
1330:
1329:
1319:
1287:
1278:
1277:
1267:
1257:
1233:
1224:
1223:
1187:
1181:
1180:
1162:
1156:
1155:
1153:
1151:
1143:
1117:
1093:
1087:
1086:
1062:
1056:
1055:
1053:
1052:
1029:
1020:
1019:
1017:
1016:
997:
991:
990:
988:
986:
967:
961:
960:
943:
934:
923:
912:
911:
909:
908:
889:
883:
882:
880:
878:
859:
779:response to food
582:
579:
532:gastric motility
221:acid indigestion
211:, also known as
110:Smoking, obesity
64:Gastroenterology
42:
41:
3044:
3043:
3039:
3038:
3037:
3035:
3034:
3033:
3019:
3018:
3017:
3012:
3011:
2988:
2987:
2942:
2928:
2923:
2884:Lockwood's sign
2832:
2805:
2776:Ballance's sign
2747:
2714:
2708:Fluid wave test
2671:
2665:Blumberg's sign
2621:
2597:Rectal tenesmus
2564:
2504:Councilman body
2486:
2429:Goodsall's rule
2417:Hypersalivation
2334:
2327:
2314:
2284:
2283:
2244:
2240:
2201:
2197:
2152:
2148:
2109:
2105:
2058:
2054:
2045:
2043:
2033:
2024:
2014:
2012:
1999:
1998:
1994:
1984:
1983:
1979:
1969:
1967:
1959:
1958:
1951:
1928:
1924:
1917:
1895:
1891:
1854:
1850:
1843:
1831:
1830:
1826:
1820:Wayback Machine
1811:
1807:
1768:
1761:
1755:Wayback Machine
1746:
1739:
1733:Wayback Machine
1724:
1717:
1696:(1): 23–33, v.
1686:
1671:
1634:
1630:
1599:
1592:
1583:
1581:
1579:medlineplus.gov
1573:
1572:
1568:
1529:
1525:
1510:
1494:
1490:
1484:Wayback Machine
1475:
1471:
1432:
1428:
1397:
1393:
1362:
1358:
1349:
1347:
1338:
1337:
1333:
1288:
1281:
1234:
1227:
1188:
1184:
1177:
1163:
1159:
1145:
1137:
1135:
1118:
1100:(4): CD001961.
1094:
1090:
1079:
1063:
1059:
1050:
1048:
1030:
1023:
1014:
1012:
999:
998:
994:
984:
982:
969:
968:
964:
957:
945:
944:
937:
924:
915:
906:
904:
891:
890:
886:
876:
874:
861:
860:
856:
851:
843:
831:
811:
795:
772:
726:
718:
691:
675:
659:
653:
644:Upper GI series
623:
559:
520:
503:
482:
470:
461:small intestine
439:
415:
385:atopic diseases
346:
336:estimates that
321:
308:
296:epigastric pain
288:
162:Crohn's disease
68:family medicine
40:
35:
24:
17:
12:
11:
5:
3042:
3032:
3031:
3014:
3013:
3010:
3009:
2997:
2996:
2994:
2990:
2989:
2986:
2985:
2974:
2959:
2943:
2938:
2937:
2935:
2934:Classification
2925:
2924:
2922:
2921:
2919:Blumer's shelf
2916:
2911:
2909:Massouh's sign
2906:
2904:Carnett's sign
2901:
2896:
2891:
2886:
2881:
2876:
2871:
2866:
2861:
2859:Hamburger sign
2856:
2854:Rovsing's sign
2851:
2849:Obturator sign
2846:
2840:
2838:
2834:
2833:
2831:
2830:
2825:
2819:
2817:
2811:
2810:
2807:
2806:
2804:
2803:
2798:
2793:
2788:
2786:Castell's sign
2783:
2778:
2773:
2768:
2767:
2766:
2755:
2753:
2749:
2748:
2746:
2745:
2744:
2743:
2738:
2728:
2726:Abdominal mass
2722:
2720:
2716:
2715:
2713:
2712:
2711:
2710:
2705:
2700:
2695:
2690:
2679:
2677:
2673:
2672:
2670:
2669:
2668:
2667:
2662:
2657:
2652:
2647:
2640:Abdominal pain
2636:
2634:
2627:
2623:
2622:
2620:
2619:
2614:
2609:
2604:
2599:
2594:
2589:
2580:
2574:
2572:
2566:
2565:
2563:
2562:
2557:
2551:
2546:
2535:
2526:
2521:
2512:
2511:
2506:
2494:
2492:
2488:
2487:
2485:
2484:
2479:
2477:Hampton's line
2467:
2466:
2461:
2456:
2451:
2446:
2441:
2436:
2431:
2425:
2424:
2419:
2414:
2409:
2404:
2399:
2398:
2397:
2392:
2382:
2381:
2380:
2375:
2370:
2360:
2355:
2350:
2345:
2339:
2337:
2329:
2328:
2313:
2312:
2305:
2298:
2290:
2282:
2281:
2254:(4): 759–765.
2238:
2195:
2146:
2103:
2052:
2022:
1992:
1977:
1949:
1938:(4): 325–332.
1922:
1915:
1889:
1848:
1841:
1824:
1805:
1778:(3): 577–582.
1759:
1737:
1715:
1669:
1628:
1609:(1): 235–261.
1590:
1566:
1539:(3): 175–190.
1523:
1508:
1488:
1469:
1426:
1391:
1372:(4): 228–234.
1356:
1331:
1302:(9): e014733.
1279:
1225:
1198:(2): 453–498.
1182:
1175:
1157:
1088:
1077:
1057:
1021:
992:
962:
955:
935:
913:
884:
853:
852:
850:
847:
842:
839:
830:
827:
826:
825:
819:
810:
807:
806:
805:
802:
799:
794:
791:
790:
789:
786:
783:
780:
771:
768:
767:
766:
759:
741:
725:
722:
717:
714:
690:
687:
674:
671:
655:Main article:
652:
649:
648:
647:
641:
634:
622:
619:
616:
615:
609:
605:
604:
601:
597:
596:
593:
589:
588:
585:
558:
557:Unknown origin
555:
554:
553:
550:
547:
519:
516:
515:
514:
502:
499:
498:
497:
481:
478:
477:
476:
469:
466:
465:
464:
454:
438:
435:
434:
433:
431:Stomach cancer
428:
414:
411:
410:
409:
398:
392:
378:
372:
367:
362:
356:
345:
342:
320:
317:
307:
304:
287:
284:
204:
203:
198:
192:
191:
185:
181:
180:
169:
165:
164:
156:, duodenitis,
131:
125:
124:
118:
112:
111:
108:
102:
101:
96:
92:
91:
81:
75:
74:
61:
55:
54:
51:
47:
46:
38:
15:
9:
6:
4:
3:
2:
3041:
3030:
3027:
3026:
3024:
3008:
3004:
3003:
2999:
2998:
2995:
2991:
2984:
2980:
2979:
2975:
2973:
2969:
2968:
2964:
2960:
2958:
2954:
2953:
2949:
2945:
2944:
2941:
2936:
2932:
2920:
2917:
2915:
2912:
2910:
2907:
2905:
2902:
2900:
2897:
2895:
2892:
2890:
2887:
2885:
2882:
2880:
2877:
2875:
2874:Dunphy's sign
2872:
2870:
2867:
2865:
2864:Heel tap sign
2862:
2860:
2857:
2855:
2852:
2850:
2847:
2845:
2842:
2841:
2839:
2835:
2829:
2826:
2824:
2821:
2820:
2818:
2816:
2812:
2802:
2799:
2797:
2796:Cullen's sign
2794:
2792:
2789:
2787:
2784:
2782:
2779:
2777:
2774:
2772:
2769:
2765:
2762:
2761:
2760:
2757:
2756:
2754:
2750:
2742:
2739:
2737:
2734:
2733:
2732:
2729:
2727:
2724:
2723:
2721:
2717:
2709:
2706:
2704:
2701:
2699:
2696:
2694:
2691:
2689:
2686:
2685:
2684:
2681:
2680:
2678:
2674:
2666:
2663:
2661:
2658:
2656:
2653:
2651:
2648:
2646:
2645:Acute abdomen
2643:
2642:
2641:
2638:
2637:
2635:
2631:
2628:
2624:
2618:
2615:
2613:
2610:
2608:
2605:
2603:
2600:
2598:
2595:
2593:
2590:
2588:
2584:
2581:
2579:
2576:
2575:
2573:
2571:
2567:
2561:
2558:
2555:
2552:
2550:
2549:Lépine's sign
2547:
2545:
2544:Murphy's sign
2541:
2540:
2539:cholecystitis
2536:
2534:
2530:
2527:
2525:
2522:
2520:
2517:
2514:
2513:
2510:
2507:
2505:
2502:
2500:
2496:
2495:
2493:
2489:
2483:
2480:
2478:
2475:
2473:
2469:
2468:
2465:
2462:
2460:
2457:
2455:
2454:Markle's sign
2452:
2450:
2449:Arapov's sign
2447:
2445:
2442:
2440:
2437:
2435:
2432:
2430:
2427:
2426:
2423:
2420:
2418:
2415:
2413:
2410:
2408:
2405:
2403:
2400:
2396:
2393:
2391:
2390:oropharyngeal
2388:
2387:
2386:
2383:
2379:
2376:
2374:
2371:
2369:
2366:
2365:
2364:
2361:
2359:
2356:
2354:
2351:
2349:
2346:
2344:
2341:
2340:
2338:
2336:
2330:
2326:
2322:
2318:
2311:
2306:
2304:
2299:
2297:
2292:
2291:
2288:
2277:
2273:
2269:
2265:
2261:
2257:
2253:
2249:
2242:
2234:
2230:
2226:
2222:
2218:
2214:
2210:
2206:
2199:
2191:
2187:
2183:
2179:
2174:
2169:
2165:
2161:
2157:
2150:
2142:
2138:
2134:
2130:
2126:
2122:
2118:
2114:
2107:
2099:
2095:
2090:
2085:
2080:
2075:
2071:
2067:
2063:
2056:
2042:
2038:
2031:
2029:
2027:
2010:
2006:
2002:
1996:
1988:
1985:"Endoscopy".
1981:
1966:
1962:
1956:
1954:
1945:
1941:
1937:
1933:
1926:
1918:
1912:
1908:
1903:
1902:
1893:
1885:
1881:
1876:
1871:
1867:
1863:
1859:
1852:
1844:
1838:
1834:
1828:
1821:
1817:
1814:
1809:
1801:
1797:
1793:
1789:
1785:
1781:
1777:
1773:
1766:
1764:
1756:
1752:
1749:
1744:
1742:
1734:
1730:
1727:
1722:
1720:
1711:
1707:
1703:
1699:
1695:
1691:
1684:
1682:
1680:
1678:
1676:
1674:
1665:
1661:
1656:
1651:
1647:
1643:
1639:
1632:
1624:
1620:
1616:
1612:
1608:
1604:
1597:
1595:
1580:
1576:
1570:
1562:
1558:
1554:
1550:
1546:
1542:
1538:
1534:
1527:
1519:
1515:
1511:
1505:
1501:
1500:
1492:
1485:
1481:
1478:
1473:
1465:
1461:
1457:
1453:
1449:
1445:
1441:
1437:
1430:
1422:
1418:
1414:
1410:
1406:
1402:
1395:
1387:
1383:
1379:
1375:
1371:
1367:
1360:
1346:on 2011-01-16
1345:
1341:
1335:
1327:
1323:
1318:
1313:
1309:
1305:
1301:
1297:
1293:
1286:
1284:
1275:
1271:
1266:
1261:
1256:
1251:
1247:
1243:
1239:
1232:
1230:
1221:
1217:
1213:
1209:
1205:
1201:
1197:
1193:
1186:
1178:
1172:
1168:
1161:
1149:
1141:
1134:
1130:
1126:
1122:
1115:
1111:
1107:
1103:
1099:
1092:
1084:
1080:
1078:9781441917300
1074:
1070:
1069:
1061:
1047:
1043:
1039:
1035:
1028:
1026:
1010:
1006:
1002:
996:
980:
976:
972:
966:
958:
952:
948:
942:
940:
933:
932:
927:
922:
920:
918:
902:
898:
894:
888:
872:
868:
864:
858:
854:
846:
838:
836:
823:
820:
817:
816:
815:
803:
800:
797:
796:
787:
784:
781:
778:
774:
773:
764:
760:
757:
753:
749:
745:
742:
739:
735:
731:
728:
727:
721:
713:
711:
707:
705:
701:
699:
695:
686:
683:
679:
670:
668:
664:
658:
645:
642:
639:
635:
632:
631:
630:
627:
614:
610:
607:
606:
602:
599:
598:
594:
591:
590:
586:
584:
583:
578:
576:
572:
568:
564:
551:
548:
545:
541:
537:
536:
535:
533:
530:, changes in
529:
525:
512:
508:
505:
504:
495:
491:
487:
484:
483:
475:
472:
471:
462:
458:
455:
452:
448:
444:
441:
440:
432:
429:
426:
425:
420:
417:
416:
407:
403:
399:
396:
393:
390:
386:
382:
379:
376:
373:
371:
368:
366:
363:
360:
357:
355:
351:
348:
347:
341:
339:
334:
330:
326:
316:
314:
303:
301:
297:
293:
283:
281:
277:
273:
269:
265:
261:
257:
252:
248:
244:
242:
238:
234:
230:
226:
222:
218:
214:
210:
202:
199:
197:
193:
189:
186:
182:
178:
174:
170:
166:
163:
159:
155:
151:
147:
143:
139:
135:
132:
130:
126:
123:
119:
117:
113:
109:
107:
103:
100:
97:
93:
90:
86:
82:
80:
76:
73:
69:
65:
62:
60:
56:
52:
48:
43:
37:
33:
29:
22:
3000:
2976:
2961:
2946:
2879:Alder's sign
2741:Splenomegaly
2736:Hepatomegaly
2602:Constipation
2537:
2515:
2509:Mallory body
2497:
2482:Klemm's sign
2470:
2444:Aaron's sign
2439:Dance's sign
2368:Trichophagia
2352:
2251:
2247:
2241:
2208:
2204:
2198:
2163:
2159:
2149:
2116:
2112:
2106:
2069:
2065:
2055:
2044:. Retrieved
2040:
2013:. Retrieved
2004:
1995:
1986:
1980:
1968:. Retrieved
1964:
1935:
1931:
1925:
1900:
1892:
1865:
1861:
1851:
1832:
1827:
1808:
1775:
1771:
1693:
1689:
1645:
1641:
1631:
1606:
1602:
1582:. Retrieved
1578:
1569:
1536:
1532:
1526:
1498:
1491:
1472:
1439:
1435:
1429:
1407:(1): 27–33.
1404:
1400:
1394:
1369:
1365:
1359:
1348:. Retrieved
1344:the original
1334:
1299:
1295:
1245:
1241:
1195:
1191:
1185:
1166:
1160:
1146:{{
1138:{{
1097:
1091:
1067:
1060:
1049:. Retrieved
1037:
1034:"Chest Pain"
1013:. Retrieved
1004:
995:
983:. Retrieved
974:
965:
946:
929:
905:. Retrieved
896:
887:
875:. Retrieved
866:
857:
844:
841:Epidemiology
832:
812:
719:
708:
702:
692:
676:
660:
628:
624:
560:
544:progesterone
521:
486:Pancreatitis
446:
422:
325:heart attack
322:
309:
289:
253:
249:
245:
233:gastric acid
220:
216:
212:
208:
207:
138:heart attack
106:Risk factors
36:
3002:MedlinePlus
2894:Cupola sign
2791:Kehr's sign
2771:Puddle sign
2402:Odynophagia
1001:"Heartburn"
926:"heartburn"
877:19 November
867:MedicineNet
822:Acupuncture
765:is present.
673:Biochemical
657:GI cocktail
651:GI cocktail
468:Gallbladder
292:indigestion
256:medications
175:use, heavy
50:Other names
2844:Psoas sign
2676:Distension
2655:Baby colic
2587:encopresis
2578:Flatulence
2570:Defecation
2560:Nardi test
2519:Boas' sign
2412:Xerostomia
2407:Bad breath
2395:esophageal
2373:Pagophagia
2358:Aerophagia
2046:2024-04-14
1584:2022-06-08
1442:(12): 73.
1350:2010-06-21
1051:2024-04-28
1038:StatPearls
1015:2015-07-24
907:2015-07-24
849:References
689:Mechanical
501:Hematology
490:autoimmune
474:Gallstones
457:Duodenitis
437:Intestines
329:chest pain
286:Definition
280:peppermint
266:, high in
217:cardialgia
196:Medication
168:Prevention
134:Chest pain
32:Chest pain
28:Heart pain
2491:Accessory
2385:Dysphagia
2378:Geophagia
2353:Heartburn
2276:206964899
2233:211036316
2190:204757299
1518:960844656
1220:216556980
1148:retracted
1140:retracted
763:H. pylori
752:gastritis
716:Treatment
704:Endoscopy
698:manometer
694:Manometry
663:lidocaine
524:pregnancy
518:Pregnancy
488:– can be
447:H. pylori
344:Esophagus
290:The term
237:esophagus
209:Heartburn
184:Treatment
142:gastritis
122:manometry
59:Specialty
45:Heartburn
3023:Category
2759:Jaundice
2688:Bloating
2612:Diarrhea
2516:biliary:
2348:Vomiting
2268:20095795
2225:32017911
2182:31618539
2141:23118600
2133:17875198
2098:29881238
2015:29 April
2009:Archived
1884:16304077
1816:Archived
1792:29352757
1751:Archived
1729:Archived
1710:19232278
1623:12635418
1553:22327302
1480:Archived
1464:40109195
1456:27807732
1421:15215788
1386:18340239
1326:32363989
1274:19360921
1212:32336336
1133:19821286
1114:16235292
1083:Archived
1046:29262011
1009:Archived
979:Archived
901:Archived
871:Archived
730:Antacids
540:estrogen
480:Pancreas
260:antacids
243:(GERD).
201:Antacids
188:Antacids
89:belching
79:Symptoms
2983:D006356
2698:Tympany
2693:Ascites
2626:Abdomen
2422:Burping
2325:abdomen
2089:5989243
1970:23 July
1944:4432845
1800:3430229
1317:7428564
1265:2668783
985:24 July
835:surgery
682:acidity
667:antacid
665:and an
413:Stomach
276:alcohol
213:pyrosis
177:alcohol
3007:003114
2815:Hernia
2719:Masses
2343:Nausea
2274:
2266:
2231:
2223:
2188:
2180:
2139:
2131:
2096:
2086:
1942:
1913:
1882:
1839:
1798:
1790:
1708:
1662:
1621:
1561:397315
1559:
1551:
1516:
1506:
1462:
1454:
1419:
1384:
1324:
1314:
1272:
1262:
1218:
1210:
1173:
1131:
1127:,
1112:
1075:
1044:
953:
732:(i.e.
710:Biopsy
158:cancer
95:Causes
85:nausea
2972:787.1
2837:Other
2752:Other
2650:Colic
2499:liver
2335:tract
2272:S2CID
2229:S2CID
2186:S2CID
2137:S2CID
1796:S2CID
1664:14050
1557:S2CID
1460:S2CID
1216:S2CID
1144:with
565:like
494:lumen
319:Heart
313:nerve
272:NSAID
264:spicy
225:chest
173:NSAID
2978:MeSH
2967:9-CM
2633:Pain
2585:and
2363:Pica
2264:PMID
2221:PMID
2178:PMID
2129:PMID
2094:PMID
2017:2018
1972:2021
1940:PMID
1911:ISBN
1880:PMID
1862:JAMA
1837:ISBN
1788:PMID
1706:PMID
1660:PMID
1619:PMID
1549:PMID
1514:OCLC
1504:ISBN
1452:PMID
1417:PMID
1382:PMID
1322:PMID
1270:PMID
1208:PMID
1171:ISBN
1129:PMID
1110:PMID
1073:ISBN
1042:PMID
987:2015
951:ISBN
879:2015
756:GERD
754:and
736:and
542:and
404:and
350:GERD
30:and
2963:ICD
2957:R12
2948:ICD
2323:or
2256:doi
2213:doi
2209:158
2168:doi
2164:381
2121:doi
2084:PMC
2074:doi
1907:656
1870:doi
1866:294
1780:doi
1698:doi
1650:doi
1611:doi
1541:doi
1444:doi
1409:doi
1405:148
1374:doi
1312:PMC
1304:doi
1260:PMC
1250:doi
1200:doi
1121:doi
1102:doi
928:at
746:or
611:No
402:CMV
327:is
227:or
219:or
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