{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,16]],"date-time":"2026-04-16T10:31:26Z","timestamp":1776335486198,"version":"3.51.2"},"reference-count":59,"publisher":"MDPI AG","issue":"23","license":[{"start":{"date-parts":[[2019,11,20]],"date-time":"2019-11-20T00:00:00Z","timestamp":1574208000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>The internet is becoming the main source of health-related information. We aimed to investigate data regarding heartburn-related searches made by Google users from Australia, Canada, Germany, Poland, the United Kingdom, and the United States. We retrospectively analyzed data from Google Ads Keywords Planner. We extracted search volumes of keywords associated with \u201cheartburn\u201d for June 2015 to May 2019. The data were generated in the respective primary language. The number of searches per 1000 Google-user years was as follows: 177.4 (Australia), 178.1 (Canada), 123.8 (Germany), 199.7 (Poland), 152.5 (United Kingdom), and 194.5 (United States). The users were particularly interested in treatment (19.0 to 41.3%), diet (4.8 to 10.7%), symptoms (2.6 to 13.1%), and causes (3.7 to 10.0%). In all countries except Germany, the number of heartburn-related queries significantly increased over the analyzed period. For Canada, Germany, Poland, and the United Kingdom, query numbers were significantly lowest in summer; there was no significant seasonal trend for Australia and the United States. The number of heartburn-related queries has increased over the past four years, and a seasonal pattern may exist in certain regions. The trends in heartburn-related searches may reflect the scale of the complaint, and should be verified through future epidemiological studies.<\/jats:p>","DOI":"10.3390\/ijerph16234591","type":"journal-article","created":{"date-parts":[[2019,11,20]],"date-time":"2019-11-20T11:06:03Z","timestamp":1574247963000},"page":"4591","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Heartburn-Related Internet Searches and Trends of Interest across Six Western Countries: A Four-Year Retrospective Analysis Using Google Ads Keyword Planner"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4394-0460","authenticated-orcid":false,"given":"Miko\u0142aj","family":"Kami\u0144ski","sequence":"first","affiliation":[{"name":"Sanprobi Sp.z.o.o. Sp.K., 70-535 Szczecin, Poland"},{"name":"Faculty of Medicine I, Poznan University of Medical Sciences, 60-780 Poznan, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Igor","family":"\u0141oniewski","sequence":"additional","affiliation":[{"name":"Department of Biochemistry and Human Nutrition, Pomeranian Medical University, 70-204 Szczecin, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Agata","family":"Misera","sequence":"additional","affiliation":[{"name":"Department of Child and Adolescent Psychiatry, Charit\u00e9 Universit\u00e4tsmedizin, 13353 Berlin, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2649-5967","authenticated-orcid":false,"given":"Wojciech","family":"Marlicz","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Pomeranian Medical University, 70-204 Szczecin, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2019,11,20]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1001\/jamasurg.2015.4233","article-title":"An Evidence-Based Approach to the Treatment of Gastroesophageal Reflux Disease","volume":"151","author":"Patti","year":"2016","journal-title":"JAMA Surg."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1711","DOI":"10.1038\/ajg.2016.432","article-title":"Functional Heartburn Overlaps with Irritable Bowel Syndrome More Often than GERD","volume":"111","author":"Frazzoni","year":"2016","journal-title":"Am. J. Gastroenterol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"267","DOI":"10.1053\/j.gastro.2017.07.045","article-title":"Presentation and Epidemiology of Gastroesophageal Reflux Disease","volume":"154","author":"Richter","year":"2018","journal-title":"Gastroenterology"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"430","DOI":"10.1136\/gutjnl-2016-313589","article-title":"Global prevalence of, and risk factors for, gastro-oesophageal reflux symptoms: A meta-analysis","volume":"67","author":"Eusebi","year":"2018","journal-title":"Gut"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"710","DOI":"10.1136\/gut.2004.051821","article-title":"Epidemiology of gastro-oesophageal reflux disease: A systematic review","volume":"54","author":"Dent","year":"2005","journal-title":"Gut"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1044","DOI":"10.3109\/00365521.2014.923504","article-title":"Use of antacids, alginates and proton pump inhibitors: A survey of the general Danish population using an internet panel","volume":"49","author":"Reimer","year":"2014","journal-title":"Scand. J. Gastroenterol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"706","DOI":"10.1053\/j.gastro.2017.01.031","article-title":"The Risks and Benefits of Long-Term Use of Proton Pump Inhibitors: Expert Review and Best Practice Advice from the American Gastroenterological Association","volume":"152","author":"Freedberg","year":"2017","journal-title":"Gastroenterology"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"6500","DOI":"10.3748\/wjg.v23.i35.6500","article-title":"Proton pump inhibitors therapy and risk of Clostridium difficile infection: Systematic review and meta-analysis","volume":"23","author":"Trifan","year":"2017","journal-title":"World J. Gastroenterol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"244","DOI":"10.1016\/j.amjmed.2017.10.034","article-title":"Inpatient Proton Pump Inhibitor Administration and Hospital-Acquired Clostridium difficile Infection: Evidence and Possible Mechanism","volume":"131","author":"Wombwell","year":"2018","journal-title":"Am. J. Med."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"80","DOI":"10.1111\/ijpp.12445","article-title":"What, where and when? Using Google Trends and Google to investigate patient needs and inform pharmacy practice","volume":"27","author":"Hanna","year":"2019","journal-title":"Int. J. Pharm. Pract."},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Martini, M., and Bragazzi, N. (2019). Googling for neurological disorders: From seeking health-related information to patient empowerment, advocacy and open self-disclosure in the Neurology 2.0 era. J. Med. Internet Res.","DOI":"10.2196\/preprints.13999"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"e128","DOI":"10.2196\/jmir.2934","article-title":"Use of the internet as a health information resource among French young adults: Results from a nationally representative survey","volume":"16","author":"Beck","year":"2014","journal-title":"J. Med. Internet Res."},{"key":"ref_13","unstructured":"McDaid, D., and Park, A.-L. (2019, October 26). Online Health: Untangling the Web. Available online: https:\/\/www.bupa.com.au\/staticfiles\/Bupa\/HealthAndWellness\/MediaFiles\/PDF\/LSE_Report_Online_Health.pdf."},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Nuti, S.V., Wayda, B., Ranasinghe, I., Wang, S., Dreyer, R.P., Chen, S.I., and Murugiah, K. (2014). The Use of Google Trends in Health Care Research: A Systematic Review. PLoS ONE, 9.","DOI":"10.1371\/journal.pone.0109583"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"e147","DOI":"10.2196\/jmir.2740","article-title":"Scoping review on search queries and social media for disease surveillance: A chronology of innovation","volume":"15","author":"Bernardo","year":"2013","journal-title":"J. Med. Internet Res."},{"key":"ref_16","unstructured":"StatCounter GlobalStats (2019, October 26). Search Engine Market Worldwide. Available online: https:\/\/gs.statcounter.com\/search-engine-market-share\/all."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"e84","DOI":"10.2196\/jmir.1991","article-title":"Accuracy of geographically targeted internet advertisements on Google AdWords for recruitment in a randomized trial","volume":"14","author":"Jones","year":"2012","journal-title":"J. Med. Internet Res."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1285","DOI":"10.1007\/s10995-019-02797-2","article-title":"Google AdWords and Facebook Ads for Recruitment of Pregnant Women into a Prospective Cohort Study with Long-Term Follow-Up","volume":"23","author":"Engelen","year":"2019","journal-title":"Matern. Child Health J."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"510","DOI":"10.1016\/j.contraception.2018.02.006","article-title":"What are people looking for when they Google \u201cself-abortion\u201d?","volume":"97","author":"Jerman","year":"2018","journal-title":"Contraception"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"151","DOI":"10.1111\/jdv.15200","article-title":"Medical needs and major complaints related to pruritus in Germany: A 4-year retrospective analysis using Google AdWords Keyword Planner","volume":"33","author":"Zink","year":"2019","journal-title":"J. Eur. Acad. Dermatol. Venereol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"e10327","DOI":"10.2196\/10327","article-title":"What Do Germans Want to Know about Skin Cancer? A Nationwide Google Search Analysis from 2013 to 2017","volume":"20","author":"Seidl","year":"2018","journal-title":"J. Med. Internet Res."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"e13739","DOI":"10.2196\/13739","article-title":"Influence of Climate on Google Internet Searches for Pruritus Across 16 German Cities: Retrospective Analysis","volume":"21","author":"Tizek","year":"2019","journal-title":"J. Med. Internet Res."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"797","DOI":"10.2340\/00015555-3214","article-title":"Interest in Skin Cancer in Urban Populations: A Retrospective Analysis of Google Search Terms in Nine Large German Cities","volume":"99","author":"Tizek","year":"2019","journal-title":"Acta Derm. Venereol."},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Wongvibulsin, S., Khanna, R., and Kwatra, S.G. (2019). Anatomic localization and quantitative analysis of the burden of itch in the United States. J. Am. Acad. Dermatol.","DOI":"10.1016\/j.jaad.2019.06.029"},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Wickham, H. (2016). Ggplot2: Elegant Graphics for Data Analysis (Use R!), Springer. [2nd ed.].","DOI":"10.1007\/978-3-319-24277-4_9"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"S154","DOI":"10.1016\/j.amepre.2011.02.006","article-title":"Infodemiology and Infoveillance","volume":"40","author":"Eysenbach","year":"2011","journal-title":"Am. J. Prev. Med."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"e289","DOI":"10.2196\/jmir.3680","article-title":"Cumulative Query Method for Influenza Surveillance Using Search Engine Data","volume":"16","author":"Seo","year":"2014","journal-title":"J. Med. Internet Res."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"e228","DOI":"10.2196\/jmir.7215","article-title":"Researching Mental Health Disorders in the Era of Social Media: Systematic Review","volume":"19","author":"Wongkoblap","year":"2017","journal-title":"J. Med. Internet Res."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"e10720","DOI":"10.2196\/10720","article-title":"Predicting Prediabetes Through Facebook Postings: Protocol for a Mixed-Methods Study","volume":"7","author":"Xu","year":"2018","journal-title":"JMIR Res. Protoc."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"e62","DOI":"10.2196\/jmir.5409","article-title":"Patterns of Treatment Switching in Multiple Sclerosis Therapies in US Patients Active on Social Media: Application of Social Media Content Analysis to Health Outcomes Research","volume":"18","author":"Risson","year":"2016","journal-title":"J. Med. Internet Res."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"e16","DOI":"10.2196\/publichealth.5304","article-title":"Leveraging Big Data to Improve Health Awareness Campaigns: A Novel Evaluation of the Great American Smokeout","volume":"2","author":"Ayers","year":"2016","journal-title":"JMIR Public Health Surveill."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"1399","DOI":"10.1001\/jama.2014.1505","article-title":"Could Behavioral Medicine Lead the Web Data Revolution?","volume":"311","author":"Ayers","year":"2014","journal-title":"JAMA"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1046\/j.1440-1746.2000.02051.x","article-title":"Heartburn: Community perceptions","volume":"15","author":"Bolin","year":"2000","journal-title":"J. Gastroenterol. Hepatol."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"952","DOI":"10.1007\/s10620-009-0885-2","article-title":"The relationship between the prevalence of nighttime gastroesophageal reflux disease and disease severity","volume":"55","author":"Dean","year":"2010","journal-title":"Dig. Dis. Sci."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"172","DOI":"10.1007\/s00455-007-9120-5","article-title":"Prevalence of dysphagia in patients with gastroesophageal reflux in Germany","volume":"23","author":"Bollschweiler","year":"2008","journal-title":"Dysphagia"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"1601","DOI":"10.1111\/j.1365-2036.2006.02924.x","article-title":"Prevalence and sociodemographics of reflux symptoms in Germany\u2014Results from a national survey","volume":"23","author":"Nocon","year":"2006","journal-title":"Aliment. Pharmacol. Ther."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"20","DOI":"10.5114\/pg.2012.27218","article-title":"Prevalence of abdominal symptoms in the Polish population","volume":"1","author":"Pacholec","year":"2012","journal-title":"Gastroenterol. Rev."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"588","DOI":"10.1007\/s10620-016-4384-y","article-title":"Using Search Engine Query Data to Explore the Epidemiology of Common Gastrointestinal Symptoms","volume":"62","author":"Hassid","year":"2017","journal-title":"Dig. Dis. Sci."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"453","DOI":"10.1097\/MAJ.0b013e3181b51fbd","article-title":"Seasonal variation in the incidence of gastroesophageal reflux disease","volume":"338","author":"Chen","year":"2009","journal-title":"Am. J. Med. Sci. USA"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"395","DOI":"10.1038\/sj.ejcn.1600761","article-title":"Changes in dietary intake account for seasonal changes in cardiovascular disease risk factors","volume":"53","author":"Shahar","year":"1999","journal-title":"Eur. J. Clin. Nutr."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1136\/gut.36.1.39","article-title":"Effect of cholecystokinin on lower oesophageal sphincter pressure and transient lower oesophageal sphincter relaxations in humans","volume":"36","author":"Ledeboer","year":"1995","journal-title":"Gut"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"519","DOI":"10.1038\/sj.ejcn.1602346","article-title":"Seasonal variation in food intake, physical activity, and body weight in a predominantly overweight population","volume":"60","author":"Ma","year":"2006","journal-title":"Eur. J. Clin. Nutr."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"337","DOI":"10.1080\/003655299750026326","article-title":"Weight loss has an independent beneficial effect on symptoms of gastro-oesophageal reflux in patients who are overweight","volume":"34","author":"Norton","year":"1999","journal-title":"Scand. J. Gastroenterol."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"501","DOI":"10.1016\/j.bpg.2017.09.004","article-title":"Tobacco smoking, alcohol consumption and gastro-oesophageal reflux disease","volume":"31","author":"Lagergren","year":"2017","journal-title":"Best Pract. Res. Clin. Gastroenterol."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1111\/ina.12121","article-title":"Seasonal variability in environmental tobacco smoke exposure in public housing developments","volume":"25","author":"Arku","year":"2015","journal-title":"Indoor Air"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1016\/S0160-4120(01)00057-5","article-title":"Seasonal assessment of environmental tobacco smoke and respirable suspended particle exposures for nonsmokers in Bremen using personal monitoring","volume":"27","author":"Phillips","year":"2001","journal-title":"Environ. Int."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"395","DOI":"10.1093\/ntr\/ntq258","article-title":"Seasonality in sales of nicotine replacement therapies: Patterns and implications for tobacco control","volume":"13","author":"Chandra","year":"2011","journal-title":"Nicotine Tob. Res."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1136\/tc.2006.018135","article-title":"Exploring the seasonality of cigarette-smoking behaviour","volume":"16","author":"Momperousse","year":"2007","journal-title":"Tob. Control"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"1592","DOI":"10.1001\/archinte.159.14.1592","article-title":"Heartburn Risk Factors, Knowledge, and Prevention Strategies: A Population-Based Survey of Individuals with Heartburn","volume":"159","author":"Oliveria","year":"1999","journal-title":"Arch. Intern. Med."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"1691","DOI":"10.1007\/s12325-016-0395-5","article-title":"Self-Care in the Twenty First Century: A Vital Role for the Pharmacist","volume":"33","author":"Bell","year":"2016","journal-title":"Adv. Ther."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"789","DOI":"10.1038\/ajg.2013.421","article-title":"Consumer use of over-the-counter proton pump inhibitors in patients with gastroesophageal reflux disease","volume":"109","author":"Sheikh","year":"2014","journal-title":"Am. J. Gastroenterol."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"635","DOI":"10.1080\/19390211.2018.1472712","article-title":"Dietary Supplement and Complementary and Alternative Medicine Use Are Highly Prevalent in Patients with Gastrointestinal Disorders: Results from an Online Survey","volume":"16","author":"Yoon","year":"2019","journal-title":"J. Diet. Suppl."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"1073","DOI":"10.1016\/j.cgh.2018.06.018","article-title":"Most Patients with Gastroesophageal Reflux Disease Who Failed Proton Pump Inhibitor Therapy Also Have Functional Esophageal Disorders","volume":"17","author":"Abdallah","year":"2019","journal-title":"Clin. Gastroenterol. Hepatol."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"258","DOI":"10.1097\/MOG.0000000000000443","article-title":"How to use Rome IV criteria in the evaluation of esophageal disorders","volume":"34","author":"Schmulson","year":"2018","journal-title":"Curr. Opin. Gastroenterol."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"1085","DOI":"10.1038\/ajg.2016.166","article-title":"We Are Using Too Many PPIs, and We Need to Stop: A European Perspective","volume":"111","author":"Lanas","year":"2016","journal-title":"Am. J. Gastroenterol."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"1676","DOI":"10.1038\/ajg.2013.112","article-title":"Patient assessments and online ratings of quality care: A \u201cwake-up call\u201d for providers","volume":"108","author":"Merrell","year":"2013","journal-title":"Am. J. Gastroenterol."},{"key":"ref_57","doi-asserted-by":"crossref","unstructured":"N\u00f6lke, L., Mensing, M., Kr\u00e4mer, A., and Hornberg, C. (2015). Sociodemographic and health-(care-) related characteristics of online health information seekers: A cross-sectional German study. BMC Public Health, 15.","DOI":"10.1186\/s12889-015-1423-0"},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"379","DOI":"10.1080\/07448481.2010.513406","article-title":"Health information-seeking in the digital age","volume":"59","author":"Percheski","year":"2011","journal-title":"J. Am. Coll. Health"},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"2214","DOI":"10.1021\/acs.jcim.8b00534","article-title":"Is Machine Translation a Reliable Tool for Reading German Scientific Databases and Research Articles?","volume":"58","author":"Zulfiqar","year":"2018","journal-title":"J. Chem. Inf. Model."}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/16\/23\/4591\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T13:35:57Z","timestamp":1760189757000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/16\/23\/4591"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,11,20]]},"references-count":59,"journal-issue":{"issue":"23","published-online":{"date-parts":[[2019,12]]}},"alternative-id":["ijerph16234591"],"URL":"https:\/\/doi.org\/10.3390\/ijerph16234591","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,11,20]]}}}