Savarino Vincenzo, Marabotto Elisa, Zentilin Patrizia, De Bortoli Nicola, Visaggi Pierfrancesco, Furnari Manuele, Bodini Giorgia, Giannini Edoardo, Savarino Edoardo
Department of Internal Medicine (DIMI), University of Genoa, Genoa, Italy.
Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy.
Expert Opin Drug Saf. 2023 Jul-Dec;22(8):643-652. doi: 10.1080/14740338.2023.2238592. Epub 2023 Jul 21.
Heartburn is a frequent symptom occurring in daily clinical practice and is mainly associated with gastroesophageal reflux disease (GERD). However, it can be stimulated by various factors and diseases other than GERD can present with heartburn. Therefore, physicians must be very careful in distinguishing GERD from non-GERD conditions in their patients, particularly when heartburn is refractory to anti-reflux medications.
The aim of this narrative review was to analyze the medical literature regarding the prevalence of heartburn and the various clinical disorders which can be present with this symptom. The type of medications usually adopted for treating heartburn and their grade of safety have been reviewed using an extensive computerized (Medline/PubMed) search with particular focus on the last 20 years.
Many drugs can be used for relieving heartburn in patients with GERD, although PPIs are the pharmacological agents with the greatest efficacy. However, it must be highlighted that many non-GERD conditions may present clinically with this symptom whose intensity does not differ between GERD and functional esophageal disorders, which represent about 50% of all patients with suspected GERD. It is very important to identify these functional conditions because their treatment differs completely from that of GERD.
烧心是日常临床实践中常见的症状，主要与胃食管反流病（GERD）相关。然而，它可由多种因素诱发，且除GERD外的其他疾病也可能出现烧心症状。因此，医生在为患者鉴别GERD与非GERD情况时必须格外谨慎，尤其是当烧心症状对抗反流药物难治时。
本叙述性综述的目的是分析关于烧心患病率以及可能伴有该症状的各种临床疾病的医学文献。通过广泛的计算机检索（Medline/PubMed），特别关注过去20年，对通常用于治疗烧心的药物类型及其安全性等级进行了综述。
许多药物可用于缓解GERD患者的烧心症状，尽管质子泵抑制剂（PPIs）是疗效最佳的药物。然而，必须强调的是，许多非GERD情况在临床上可能表现为此症状，其强度在GERD和功能性食管疾病之间并无差异，而功能性食管疾病约占所有疑似GERD患者的50%。识别这些功能性情况非常重要，因为它们的治疗与GERD完全不同。
