Heartburn is the sense of burning or warmth felt in the chest, often with radiation from the epigastrium to the neck.
Heartburn usually begins in the esophagus, but, if persistent, can raise the possibility of ischemic heart disease.
Test-and-treat for H pylori appears a cost-effective approach and reduced overall numbers of upper endoscopy (Duggan et al, 2008). However, endoscopy should be considered in older adults and those at increased risk of malignancy for other reasons.
Duggan AE et al. 2008. Clinical trial: a randomised trial of early endoscopy, H.pylori testing and empirical therapy for the management of dyspepsia in primary care. Aliment Pharmacol Ther. 29:55-68.