1. HEARTBURN By Prof.MAHMOUD ABDEL-MONEIM CLINICAL PHARMCY DEPT FACULTY OF PHARMACY KAAU

3. DEFINITION Heartburn typically is described as a burning sensation or pain located in the lower chest. Symptoms usually occur soon after meals and when lying down at bedtime CAUSE: Gastroesophageal reflux

4. PRECIPITATING FACTORS -Hiatus hernia -Obesity -Large-sized meals -Immediate lying down after meals -Wearing tight fitting clothing -Smoking -Alcohol intake -Foods that irritate the esophagus (Tomato-based products; caffeine-containing beverages) -Foods that reduce LES tone (chocolate, mints, high fat foods ) -Drugs that reduce LES tone (CCBs; Nitrates ; Anti- cholinergic drugs; Oral contraceptives and estrogen )

5. COMPLICATIONS ROLE OF PHARMACIST TREATMENT Lifestyle modification Drug therapy ( Antacids; H2HRA; PPIs ) Surgery

6. CHOICE OF THERAPY -Mild\occasional symptoms -Persistent symptoms -Persistent symptoms + mucosal damage -Refractory disease