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Flight planning

Flight planning is the process of producing a flight plan to describe a proposed aircraft flight. It involves two safety-critical aspects: fuel calculation, to ensure that the aircraft can safely reach the destination, and compliance with air traffic control requirements, to minimise the risk of midair collision. In addition, flight planners normally wish to minimise flight cost through the appropriate choice of route, height, and speed, and by loading the minimum necessary fuel on board. Air Traffic Services (ATS) use the completed flight plan for separation of aircraft in air traffic management services, including tracking and finding lost aircraft, during search and rescue (SAR) missions.

Flight planning requires accurate weather forecasts so that fuel consumption calculations can account for the fuel consumption effects of head or tail winds and air temperature. Safety regulations require aircraft to carry fuel beyond the minimum needed to fly from origin to destination, allowing for unforeseen circumstances or for diversion to another airport if the planned destination becomes unavailable. Furthermore, under the supervision of air traffic control, aircraft flying in controlled airspace must follow predetermined routes known as airways (at least where they have been defined), even if such routes are not as economical as a more direct flight. Within these airways, aircraft must maintain flight levels, specified altitudes usually separated vertically by 1000 or, depending on the route being flown and the direction of travel. When aircraft with only two engines are flying long distances across oceans, deserts, or other areas with no airports, they have to satisfy additional ETOPS safety rules to ensure they can reach an emergency airport if one engine fails.

Producing an accurate optimised flight plan requires millions of calculations, so commercial flight planning systems make extensive use of computers (an approximate unoptimised flight plan can be produced using an E6B and a map in an hour or so, but more allowance must be made for unforeseen circumstances). When computer flight planning replaced manual flight planning for eastbound flights across the North Atlantic, the average fuel consumption was reduced by about 1000 lbs per flight, and the average flight times were reduced by about 5 minutes per flight. Some commercial airlines have their own internal flight planning system, while others employ the services of external planners.

A licensed flight dispatcher or flight operations officer is required by law to carry out flight planning and flight watch tasks in many commercial operating environments (e.g., US FAR §121, Canadian regulations). These regulations vary by country but more and more countries require their airline operators to employ such personnel.

Overview and basic terminology
A flight planning system may need to produce more than one flight plan for a single flight:
 * summary plan for air traffic control (in FAA and/or ICAO format)
 * summary plan for direct download into an onboard flight management system
 * detailed plan for use by pilots

The basic purpose of a flight planning system is to calculate how much trip fuel is needed in the air navigation process by an aircraft when flying from an origin airport to a destination airport. Aircraft must also carry some reserve fuel to allow for unforeseen circumstances, such as an inaccurate weather forecast, or air traffic control requiring an aircraft to fly at a lower-than-optimal altitude due to airway congestion, or the addition of last-minute passengers whose weight was not accounted for when the flight plan was prepared. The way in which reserve fuel is determined varies greatly, depending on airline and locality. The most common methods are:
 * US domestic operations conducted under Instrument Flight Rules: enough fuel to fly to the first point of intended landing, then fly to an alternate airport (if weather conditions require an alternate airport), then for 45 minutes thereafter at normal cruising speed
 * percentage of time: typically 10% (i.e., a 10-hour flight needs enough reserve to fly for another hour)
 * percentage of fuel: typically 5% (i.e., a flight requiring 20,000 kg of fuel needs a reserve of 1,000 kg)

Except for some US domestic flights, a flight plan normally has an alternate airport as well as a destination airport. The alternate airport is for use in case the destination airport becomes unusable while the flight is in progress (due to weather conditions, a strike, a crash, terrorist activity, etc.). This means that when the aircraft gets near the destination airport, it must still have enough alternate fuel and alternate reserve available to fly on to the alternate airport. Since the aircraft is not expected at the alternate airport, it must also have enough holding fuel to circle for a while (typically 30 minutes) near the alternate airport while a landing slot is found. United States domestic flights are not required to have sufficient fuel to proceed to an alternate airport when the weather at the destination is forecast to be better than 2000 ft ceilings and 3 statute miles of visibility; however, the 45-minute reserve at normal cruising speed still applies.

It is often considered a good idea to have the alternate some distance away from the destination (e.g., 185 km) so that bad weather is unlikely to close both the destination and the alternate; distances of up to 960 km are not unknown. In some cases the destination airport may be so remote (e.g., a Pacific island) that there is no feasible alternate airport; in such a situation an airline may instead include enough fuel to circle for 2 hours near the destination, in the hope that the airport will become available again within that time.

There is often more than one possible route between two airports. Subject to safety requirements, commercial airlines generally wish to minimise costs by appropriate choice of route, speed, and height.

Various names are given to weights associated with an aircraft and/or the total weight of the aircraft at various stages.
 * Payload is the total weight of the passengers, their luggage, and any cargo. A commercial airline makes its money by charging to carry payload.
 * Operating weight empty is the basic weight of the aircraft when ready for operation, including crew but excluding any payload or usable fuel.
 * Zero fuel weight is the sum of operating weight empty and payload—that is, the laden weight of an aircraft, excluding any usable fuel.
 * Ramp weight is the weight of an aircraft at the terminal building when ready for departure. This includes the zero fuel weight and all required fuel.
 * Brake release weight is the weight of an aircraft at the start of a runway, just prior to brake release for takeoff. This is the ramp weight minus any fuel used for taxiing. Major airports may have runways that are about 2 miles (3 km) long, so merely taxiing from the terminal to the end of the runway might consume up to a ton of fuel. After taxiing, the pilot lines up the aircraft with the runway and puts the brakes on. On receiving takeoff clearance, the pilot throttles up the engines and releases the brakes to start accelerating along the runway in preparation for taking off.
 * Takeoff weight is the weight of an aircraft as it takes off partway along a runway. Few flight planning systems calculate the actual takeoff weight; instead, the fuel used for taking off is counted as part of the fuel used for climbing up to the normal cruise height.
 * Landing weight is the weight of an aircraft as it lands at the destination. This is the brake release weight minus the trip fuel burned. It includes the zero fuel weight, unusable fuel, and all alternate, holding, and reserve fuel.

When twin-engine aircraft are flying across oceans, deserts, and the like, the route must be carefully planned so that the aircraft can always reach an airport, even if one engine fails. The applicable rules are known as ETOPS (ExTended range OPerationS). The general reliability of the particular type of aircraft and its engines and the maintenance quality of the airline are taken into account when specifying how long such an aircraft may fly with only one engine operating (typically 1–3 hours).

Flight planning systems must be able to cope with aircraft flying below sea level, which will often result in a negative altitude. For example, Amsterdam Schiphol Airport has an elevation of −3 metres. The surface of the Dead Sea is 417 metres below sea level, so low-level flights in this vicinity can be well below sea level.

Units of measurement
Flight plans mix metric and non-metric units of measurement. The particular units used may vary by aircraft, airline, and location across a flight.

Since 1979, the International Civil Aviation Organization (ICAO) has recommended a unification of units of measurement within aviation based on the International System of Units (SI). Since 2010, ICAO recommends using:
 * Kilometers per hour (km/h) for speed during travel.
 * Meters per second (m/s) for wind speed during landing.
 * Kilometers (km) for distance.
 * Meters (m) for elevation.

However, a termination date for completion of metrication has not been established. While SI units technically are preferred, various non-SI units are still in widespread use within commercial aviation:
 * Knots (kn) for speed.
 * Nautical mile (nm) for distance.
 * Foot (ft) for elevation.

Distance units
Distances are nearly always measured in nautical miles, as calculated at a height of 32000 ft, compensated for the fact that the earth is an oblate spheroid rather than a perfect sphere. Aviation charts always show distances as rounded to the nearest nautical mile, and these are the distances that are shown on a flight plan. Flight planning systems may need to use the unrounded values in their internal calculations for improved accuracy.

Fuel units
Fuel measurement will vary on the gauges fitted to a particular aircraft. The most common unit of fuel measurement is kilograms; other possible measures include pounds, UK gallons, US gallons, and litres. When fuel is measured by weight, the specific gravity of the fuel used is taken into account when checking tank capacity.

There has been at least one occasion on which an aircraft ran out of fuel due to an error in converting between kilograms and pounds. In this particular case the flight crew managed to glide to a nearby runway and land safely (the runway was one of two at a former airport then being used as a dragstrip).

Many airlines request that fuel quantities be rounded to a multiple of 10 or 100 units. This can cause some interesting rounding problems, especially when subtotals are involved. Safety issues must also be considered when deciding whether to round up or down.

Height units
The altitude of an aircraft is based on the use of a pressure altimeter (see flight level for more detail). The heights quoted here are thus the nominal heights under standard conditions of temperature and pressure rather than the actual heights. All aircraft operating on flight levels calibrate altimeters to the same standard setting regardless of the actual sea level pressure, so little risk of collision arises.

In most areas, height is reported as a multiple of 100 ft, i.e. A025 is nominally 2500 ft. When cruising at higher altitudes aircraft adopt flight levels (FLs). Flight levels are altitudes corrected and calibrated against the International Standard Atmosphere (ISA). These are expressed as a three-figure group e.g., FL320 is 32000 ft ISA.

In most areas, the vertical separation between aircraft is either 1000 or.

In Russia, China and some neighbouring areas, altitudes are measured in metres. The vertical separation between aircraft is either 300 metres or 600 metres (about 1.6% less than 1,000 or 2,000 feet).

Until 1999, the vertical separation between aircraft flying at high altitudes on the same airway was 2000 ft. Since then there has been a phased introduction around the world of reduced vertical separation minimum (RVSM). This cuts the vertical separation to 1000 ft between flight levels 290 and 410 (the exact limits vary slightly from place to place). Since most jet aircraft operate between these heights, this measure effectively doubles the available airway capacity. To use RVSM, aircraft must have certified altimeters, and autopilots must meet more accurate standards.

Speed units
Aircraft cruising at lower altitudes normally use knots as the primary speed unit, while aircraft that are higher (above Mach Crossover Altitude) normally use Mach number as the primary speed unit, though flight plans often include the equivalent speed in knots as well (the conversion includes allowance for temperature and height). In a flight plan, a Mach number of "Point 82" means that the aircraft is travelling at 0.820 (82%) of the speed of sound.

The widespread use of global positioning systems (GPS) allows cockpit navigation systems to provide air speed and ground speed more or less directly.

Another method of obtaining speed and position is the inertial navigation system (INS), which keeps track of a vehicle's acceleration using gyroscopes and linear accelerometers; this information can then be integrated in time to obtain speed and position, as long as the INS was properly calibrated before departure. INS has been present in civil aviation for a few decades and is mostly used in medium to large aircraft as the system is fairly complex.

If neither GPS or INS is used, the following steps are required to obtain speed information:
 * An airspeed indicator is used to measure indicated airspeed (IAS) in knots.
 * IAS is converted to calibrated airspeed (CAS) using an aircraft-specific correction table.
 * CAS is converted to equivalent airspeed (EAS) by allowing for compressibility effects.
 * EAS is converted to true airspeed (TAS) by allowing for density altitude (i.e., height and temperature).
 * TAS is converted to ground speed by allowing for any head or tail wind.

Mass units
The weight of an aircraft is most commonly measured in kilograms, but may sometimes be measured in pounds, especially if the fuel gauges are calibrated in pounds or gallons. Many airlines request that weights be rounded to a multiple of 10 or 100 units. Great care is needed when rounding to ensure that physical constraints are not exceeded.

When chatting informally about a flight plan, approximate weights of fuel and/or aircraft may be referred to in tons. This "ton" is generally either a metric tonne or a UK long ton, which differ by less than 2%, or a short ton, which is about 10% less.

Describing a route
A route is a description of the path followed by an aircraft when flying between airports. Most commercial flights will travel from one airport to another, but private aircraft, commercial sightseeing tours, and military aircraft may do a circular or out-and-back trip and land at the same airport from which they took off.

Components
Aircraft fly on airways under the direction of air traffic control. An airway has no physical existence, but can be thought of as a motorway in the sky. On an ordinary motorway, cars use different lanes to avoid collisions, while on an airway, aircraft fly at different flight levels to avoid collisions. One can often see planes passing directly above or below one's own. Charts showing airways are published and are usually updated every 4 weeks, coinciding with the AIRAC cycle. AIRAC (Aeronautical Information Regulation and Control) occurs every fourth Thursday, when every country publishes its changes, which are usually to airways.

Each airway starts and finishes at a waypoint, and may contain some intermediate waypoints as well. Waypoints use five letters (e.g., PILOX), and those that double as non-directional beacons use three or two (TNN, WK). Airways may cross or join at a waypoint, so an aircraft can change from one airway to another at such points. A complete route between airports often uses several airways. Where there is no suitable airway between two waypoints, and using airways would result in a somewhat roundabout route, air traffic control may allow a direct waypoint-to-waypoint routing, which does not use an airway (often abbreviated in flight plans as "DCT").

Most waypoints are classified as compulsory reporting points; that is, the pilot (or the onboard flight management system) reports the aircraft's position to air traffic control as the aircraft passes a waypoint. There are two main types of waypoints:
 * A named waypoint appears on aviation charts with a known latitude and longitude. Such waypoints over land often have an associated radio beacon so that pilots can more easily check where they are. Useful named waypoints are always on one or more airways.
 * A geographic waypoint is a temporary position used in a flight plan, usually in an area where there are no named waypoints (e.g., most oceans in the Southern Hemisphere). Air traffic control require that geographic waypoints have latitudes and longitudes that are a whole number of degrees.

Note that airways do not connect directly to airports.
 * After takeoff, an aircraft follows a departure procedure (standard instrument departure, or SID), which defines a pathway from an airport runway to a waypoint on an airway, so that the aircraft can join the airway system in a controlled manner. Most of the climb portion of a flight will take place on the SID.
 * Before landing, an aircraft follows an arrival procedure (standard terminal arrival route, or STAR), which defines a pathway from a waypoint on an airway to an airport runway, so that the aircraft can leave the airway system in a controlled manner. Much of the descent portion of a flight will take place on a STAR.

Special routes known as ocean tracks are used across some oceans, mainly in the Northern Hemisphere, to increase traffic capacity on busy routes. Unlike ordinary airways, which change infrequently, ocean tracks change twice a day, so as to take advantage of favourable winds. Flights going with the jet stream may be an hour shorter than those going against it. Ocean tracks may start and finish about 100 miles offshore at named waypoints, to which a number of airways connect. Tracks across northern oceans are suitable for east–west or west–east flights, which constitute the bulk of the traffic in these areas.

Complete routes
There are a number of ways of constructing a route. All scenarios using airways use SIDs and STARs for departure and arrival. Any mention of airways might include a very small number of "direct" segments to allow for situations when there are no convenient airway junctions. In some cases, political considerations may influence the choice of route (e.g., aircraft from one country cannot overfly some other country).
 * Airway(s) from origin to destination. Most flights over land fall into this category.
 * Airway(s) from origin to an ocean edge, then an ocean track, then airway(s) from ocean edge to destination. Most flights over northern oceans fall into this category.
 * Airway(s) from origin to an ocean edge, then a free-flight area across an ocean, then airway(s) from ocean edge to destination. Most flights over southern oceans fall into this category.
 * Free-flight area from origin to destination. This is a relatively uncommon situation for commercial flights.

Even in a free-flight area, air traffic control still requires a position report about once an hour. Flight planning systems organise this by inserting geographic waypoints at suitable intervals. For a jet aircraft, these intervals are 10 degrees of longitude for eastbound or westbound flights and 5 degrees of latitude for northbound or southbound flights. In free-flight areas, commercial aircraft normally follow a least-time-track so as to use as little time and fuel as possible. A great circle route would have the shortest ground distance, but is unlikely to have the shortest air distance, due to the effect of head or tail winds. A flight planning system may have to perform significant analysis to determine a good free-flight route.

Fuel calculation
Calculation of fuel requirements (especially trip fuel and reserve fuel) is the most safety-critical aspect of flight planning. This calculation is somewhat complicated:
 * Rate of fuel burn depends on ambient temperature, aircraft speed, and aircraft altitude, none of which are entirely predictable.
 * Rate of fuel burn also depends on airplane weight, which changes as fuel is burned.
 * Some iteration is generally required due to the need to calculate interdependent values. For instance, reserve fuel is often calculated as a percentage of trip fuel, but trip fuel cannot be calculated until the total weight of the aircraft is known, and this includes the weight of the reserve fuel.

Considerations
Fuel calculation must take many factors into account.
 * Weather forecasts
 * The air temperature affects the efficiency/fuel consumption of aircraft engines. The wind may provide a head- or tailwind component, which in turn will increase or decrease the fuel consumption by increasing or decreasing the air distance to be flown.

 * By agreement with the International Civil Aviation Organization, there are two national weather centres - in the United States, the National Oceanic and Atmospheric Administration, and in the United Kingdom, the Met Office - which provide worldwide weather forecasts for civil aviation in a format known as GRIB weather. These forecasts are generally issued every 6 hours and cover the subsequent 36 hours. Each 6-hour forecast covers the whole world using grid points located at intervals of 75 nmi or less. At each grid point, the wind speed, wind direction, air temperature is supplied at nine different heights between 4500 and 55000 ft.

 * Aircraft seldom fly exactly through weather gridpoints or at the exact heights at which weather predictions are available, so some form of horizontal and vertical interpolation is generally needed. For 75 nmi intervals, linear interpolation is satisfactory. The GRIB format superseded the earlier ADF format in 1998–99. The ADF format used 300 nmi intervals; this interval was large enough to miss some storms completely, so calculations using ADF-predicted weather were often not as accurate as those that can be produced using GRIB-predicted weather.

 * Routes and flight levels
 * The particular route to be flown determines the ground distance to cover, while winds on that route determine the air distance to be flown. Each inter-waypoint portion of an airway may have different rules as to which flight levels may be used. Total aircraft weight at any point determines the highest flight level which can be used. Cruising at a higher flight level generally requires less fuel than at a lower flight level, but extra climb fuel may be needed to get up to the higher flight level (it is this extra climb fuel and the different fuel consumption rate that cause discontinuities).

 * Physical constraints
 * Almost all the weights mentioned above in "Overview and basic terminology" may be subject to minimum and/or maximum values. Due to stress on the wheels and undercarriage when landing, the maximum safe landing weight may be considerably less than the maximum safe brake-release weight. In such cases, an aircraft that encounters some emergency and has to land immediately after taking off may have to circle for a while to use up fuel, or else jettison some fuel, or else land immediately and risk having the undercarriage collapse.

 * Further, the fuel tanks have a maximum capacity. On some occasions, commercial flight planning systems find that an impossible flight plan has been requested. The aircraft cannot possibly reach the intended destination, even with no cargo or passengers, since the fuel tanks are not big enough to hold the amount of fuel needed; it would appear that some airlines are over-optimistic at times, perhaps hoping for a (very) strong tailwind.

 * Fuel consumption rate
 * The rate of fuel consumption for aircraft engines depends on the air temperature, height as measured by air pressure, aircraft weight, aircraft speed relative to the air, and any increased consumption as compared with brand-new engines due to engine age and/or poor maintenance (an airline can estimate this degradation by comparing actual with predicted fuel burn). Note that a large aircraft, such as a jumbo jet, may burn up to 80 tons of fuel on a 10-hour flight, so there is a substantial weight change during the flight.

Calculation
The weight of fuel forms a significant part of the total weight of an aircraft, so any fuel calculation must take into account the weight of any fuel not yet burned. Instead of trying to predict the fuel load not yet burned, a flight planning system can handle this situation by working backward along the route, starting at the alternate, going back to the destination, and then going back waypoint by waypoint to the origin.

A more detailed outline of the calculation follows. Several (possibly many) iterations are usually required, either to calculate interdependent values such as reserve fuel and trip fuel, or to cope with situations where some physical constraint has been exceeded. In the latter case it is usually necessary to reduce the payload (less cargo or fewer passengers). Some flight planning systems use elaborate systems of approximate equations to simultaneously estimate all the changes required; this can greatly reduce the number of iterations needed.

 * If an aircraft lands at the alternate, in the worst case it can be assumed to have no fuel left (in practice there will be enough reserve fuel left to at least taxi off the runway). Hence a flight planning system can calculate alternate holding fuel on the basis that the final aircraft weight is the zero fuel weight. Since the aircraft is circling while holding, there is no need to take wind into account for this or any other holding calculation.

 * For the flight from destination to alternate, a flight planning system can calculate alternate trip fuel and alternate reserve fuel on the basis that the aircraft weight on reaching the alternate is zero fuel weight plus alternate holding.

 * A flight planning system can then calculate any destination holding on the basis that the final aircraft weight is zero fuel weight plus alternate holding plus alternate fuel plus alternate reserve.

 * For the flight from origin to destination, the weight on arrival at the destination can be taken as zero fuel weight plus alternate holding plus alternate fuel plus alternate reserve plus destination holding. A flight planning system can then work back along the route, calculating the trip fuel and reserve fuel one waypoint at a time, with the fuel required for each inter-waypoint segment forming part of the aircraft weight for the next segment to be calculated.

 * At each stage and/or at the end of the calculation, a flight planning system must carry out checks to ensure that physical constraints (e.g., maximum tank capacity) have not been exceeded. Problems mean that either the aircraft weight must be reduced in some way or the calculation must be abandoned.

An alternative approach to fuel calculation is to calculate alternate and holding fuel as above and obtain some estimate of the total trip fuel requirement, either based on previous experience with that route and aircraft type, or by using some approximate formula; neither method can take much account of weather. Calculation can then proceed forward along the route, waypoint by waypoint. On reaching the destination, the actual trip fuel can be compared with the estimated trip fuel, a better estimate made, and the calculation repeated as required.

Cost reduction
Commercial airlines generally wish to keep the cost of a flight as low as possible. There are three main factors that contribute to the cost:
 * the amount of fuel needed (to complicate matters, fuel may cost different amounts at different airports),
 * actual flying time affects depreciation charges, maintenance schedules, and the like,
 * overflight charges are levied by each country the aircraft flies over (notionally to cover air traffic control costs).

Different airlines have different views as to what constitutes a least-cost flight:
 * least cost based only on time
 * least cost based only on fuel
 * least cost based on a balance between fuel and time
 * least cost based on fuel costs and time costs and overflight charges

Basic improvements
For any given route, a flight planning system can reduce cost by finding the most economical speed at any given altitude and by finding the best altitude(s) to use based on the predicted weather. Such local optimisation can be done on a waypoint-by-waypoint basis.

Commercial airlines do not want an aircraft to change altitude too often (among other things, it may make it more difficult for the cabin crew to serve meals), so they often specify some minimum time between optimisation-related flight level changes. To cope with such requirements, a flight planning system must be capable of non-local altitude optimisation by simultaneously taking a number of waypoints into account, along with the fuel costs for any short climbs that may be required.

When there is more than one possible route between the origin and destination airports, the task facing a flight planning system becomes more complicated, since it must now consider many routes in order to find the best available route. Many situations have tens or even hundreds of possible routes, and there are some situations with over 25,000 possible routes (e.g., London to New York with free-flight below the track system). The amount of calculation required to produce an accurate flight plan is so substantial that it is not feasible to examine every possible route in detail. A flight planning system must have some fast way of cutting the number of possibilities down to a manageable number before undertaking a detailed analysis.

Reserve reduction
From an accountant's viewpoint, the provision of reserve fuel costs money (the fuel needed to carry the hopefully unused reserve fuel). Techniques known variously as reclear, redispatch, or decision point procedure have been developed, which can greatly reduce the amount of reserve fuel needed while still maintaining all required safety standards. These techniques are based on having some specified intermediate airport to which the flight can divert if necessary; in practice such diversions are rare. The use of such techniques can save several tons of fuel on long flights, or it can increase the payload carried by a similar amount.

A reclear flight plan has two destinations. The final destination airport is where the flight is really going to, while the initial destination airport is where the flight will divert to if more fuel is used than expected during the early part of the flight. The waypoint at which the decision is made as to which destination to go to is called the reclear fix or decision point. On reaching this waypoint, the flight crew make a comparison between actual and predicted fuel burn and check how much reserve fuel is available. If there is sufficient reserve fuel, then the flight can continue to the final destination airport; otherwise the aircraft must divert to the initial destination airport.

The initial destination is positioned so that less reserve fuel is needed for a flight from the origin to the initial destination than for a flight from the origin to the final destination. Under normal circumstances, little if any of the reserve fuel is actually used, so when the aircraft reaches the reclear fix it still has (almost) all the original reserve fuel on board, which is enough to cover the flight from the reclear fix to the final destination.

The idea of reclear flights was first published in Boeing Airliner (1977) by Boeing engineers David Arthur and Gary Rose. The original paper contains a lot of magic numbers relating to the optimum position of the reclear fix and so on. These numbers apply only to the specific type of aircraft considered, for a specific reserve percentage, and take no account of the effect of weather. The fuel savings due to reclear depend on three factors:
 * The maximum achievable saving depends on the position of the reclear fix. This position cannot be determined theoretically since there are no exact equations for trip fuel and reserve fuel. Even if it could be determined exactly, there may not be a waypoint at the right place.
 * One factor identified by Arthur and Rose that helps achieve the maximum possible saving is to have an initial destination positioned so that descent to the initial destination starts immediately after the reclear fix. This is beneficial because it minimises the reserve fuel needed between reclear fix and initial destination, and hence maximises the amount of reserve fuel available at the reclear fix.
 * The other factor which is also helpful is the positioning of the initial alternate airport.

Filing suboptimal plans
Despite all the effort taken to optimise flight plans, there are certain circumstances in which it is advantageous to file suboptimal plans. In busy airspace with a number of competing aircraft, the optimum routes and preferred altitudes may be oversubscribed. This problem can be worse in busy periods, such as when everyone wants to arrive at an airport as soon as it opens for the day. If all the aircraft file optimal flight plans then to avoid overloading, air traffic control may refuse permission for some of the flight plans or delay the allocated takeoff slots. To avoid this a suboptimal flight plan can be filed, asking for an inefficiently low altitude or a longer, less congested route.

Once airborne, part of the pilot's job is to fly as efficiently as possible so he/she might then try to convince air traffic control to allow them to fly closer to the optimum route. This might involve requesting a higher flight level than in the plan or asking for a more direct routing. If the controller does not immediately agree, it may be possible to re-request occasionally until they relent. Alternatively, if there has been any bad weather reported in the area, a pilot might request a climb or turn to avoid weather.

Even if the pilot does not manage to revert to the optimal route, the benefits of being allowed to fly may well outweigh the cost of the suboptimal route.

VFR flights
Although VFR flights often do not require filing a flight plan, a certain amount of flight planning remains necessary. The captain has to make sure that there will be enough fuel on board for the trip and sufficient reserve fuel for unforeseen circumstances. Weight and centre of gravity must remain within their limits during the whole flight. The captain must prepare an alternate flight plan for when landing at the original destination is not possible.

In Canada, however, the regulations state that "... no pilot-in-command shall operate an aircraft in VFR flight unless a VFR flight plan or a VFR flight itinerary has been filed, except where the flight is conducted within 25 NM of the departure aerodrome."

Additional features
Over and above the various cost-reduction measures mentioned above, flight planning systems may offer extra features to help attract and retain customers:
 * Other routes
 * While a flight plan is produced for a specific route, flight dispatchers may wish to consider alternative routes. A flight planning system may produce summaries for, say, the next 4 best routes, showing zero fuel weight and total fuel for each possibility.
 * Reclear selection
 * There may be several possible reclear fixes and initial destinations, and which one is best depends on the weather and the zero fuel weight. A flight planning system can analyse each possibility and select whichever is best for this particular flight.
 * What-if summaries
 * On congested routes, air traffic control may require that an aircraft fly lower or higher than optimum. The total weight of passengers and cargo might not be known at the time the flight plan is prepared. To allow for these situations a flight planning system may produce summaries showing how much fuel would be needed if the aircraft is a little lighter or heavier, or if it is flying higher or lower than planned. These summaries allow flight dispatchers and pilots to check if there is enough reserve fuel to cope with a different scenario.
 * Fuel tank distribution
 * Most commercial aircraft have more than one fuel tank, and an aircraft manufacturer may provide rules as to how much fuel to load into each tank so as to avoid affecting the aircraft centre of gravity. The rules depend on how much fuel is to be loaded, and there may be different sets of rules for different total amounts of fuel. A flight planning system may follow these rules and produce a report showing how much fuel is to be loaded into each tank.
 * Tankering fuel
 * When aviation fuel prices differ between airports, it can be worth putting in more fuel where it is cheap, even taking into account the cost of extra trip fuel needed to carry the extra weight. A flight planning system can work out how much extra fuel will maximise profit. Note that discontinuities due to changes in flight levels can mean that a difference of as little as 100 kg (one passenger with luggage) in zero fuel weight or tankering fuel can make the difference between profit and loss.
 * Inflight diversion
 * While en route, an aircraft may be diverted to some airport other than the planned alternate. A flight planning system can produce a new flight plan for the new route from the diversion point and transmit it to the aircraft, including a check that there will be enough fuel for the revised flight.
 * Inflight refuelling
 * Military aircraft may refuel in midair. Such refuelling is a process rather than instantaneous. Some flight planning systems can allow for the change in fuel and show the effect on each aircraft involved.

title: Flight planning


text:
Wikipedia:Articles for deletion/Farmer and Irwin

 This page is an archive of the proposed deletion of the article below. Further comments should be made on the appropriate discussion page (such as the article's talk page or on a Votes for Undeletion nomination). No further edits should be made to this page.

The result of the debate was delete. Sjakkalle (Check!)  11:59, 25 July 2005 (UTC)

Farmer and Irwin
Advertising for a non-notable company. Delete. --Dmcdevit·t 20:30, July 13, 2005 (UTC)
 * Delete per above. Dcarrano 23:37, July 13, 2005 (UTC)
 * Delete advertising. JamesBurns 08:54, 14 July 2005 (UTC)
 * Delete - advert - Tεx  τ  urε  20:03, 19 July 2005 (UTC)
 * The above discussion is preserved as an archive of the debate. Please do not modify it. Subsequent comments should be made on the appropriate discussion page (such as the article's talk page or in an undeletion request). No further edits should be made to this page.

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Talk:Heartburn

Generally inaccurate and misleading
This whole article is full of inaccuracies and references that do not support the claims made, notably that 'heartburn' is a symptom of IHD and that it is synonymous with GERD. It really needs to be totally rewritten — Preceding unsigned comment added by 130.56.76.63 (talk) 14:22, 16 July 2012 (UTC)

Ambiguous sentence
"It however may also be a symptom of ischemic heart disease so concluding that it is heartburn prematurely may lead to misdiagnosis."

This suggests that "It" i.e., heartburn, may be a symptom of something else. This, however, is probably not the intended meaning of this sentence. The intended meaning is probably that heartburn and ischemic heart disease share a common set of symptoms and hence there is risk of misdiagnosis. The current text suggests: heartburn is a symptom of ischemic heart disease.

In any case, this should be reworded to avoid such ambiguity and so that it reads better ("It however may ..." bad form, no commas.) —Preceding unsigned comment added by 108.7.10.101 (talk) 02:34, 28 December 2010 (UTC)

More info added
k —Preceding unsigned comment added by 69.50.81.21 (talk) 07:06, 4 October 2007 (UTC) Added short descriptions of diagnostic tests, expanded the treatments section, etc. I wonder if the stub status should be removed....

Some of the changes come from MediPrimer:Heartburn and GERD. As the copyright holder of that text, I authorize the use of this text under the GFDL as part of Wikipedia. Yashka78 20:30, 13 July 2005 (UTC)

Pregnancy
I'm a wikinewbie. Maybe someone could add pregnancy as a cause of hearburn? Reference http://www.babycenter.com/refcap/pregnancy/prenatalhealth/242.html googhie 02:58, 17 October 2006 (UTC)Googhie

 * Pregnancy can indeed be a cause, but let's leave that site out, it's not a reputable medical source.--Steven Fruitsmaak (Reply) 16:36, 9 November 2006 (UTC)

I'm also a wikinewbie. I can't understand how pregnancy can be simply left out of this page, even if the above is not a reputable medical source. Ask any medical doctor is heartburn is a common condition in pregnancy. BTW I've heard that heartburn is alleviated by lying on the right, since the stomach drains downwards better that way. Further ideas for this page is to explore how pregnancy is associated with heartburn - I heard it is associated with the stomach valve being pushed up (by the expanding uterus) to the upper region of the abdomen, where the pressure induces the acid reflux. Does anyone know if this is true? Accurate awareness of what is going on internally could potentially be helpful to sufferersWikiwhich85 (talk) 09:23, 14 December 2008 (UTC)wikiwhich85

I dont think heartburn should be automatically grouped in with GERD. I have GERD and have never experienced heartburn. Yes it should be listed as a linked symptom and so readers can be redirected.

Merge?
This article is about heartburn, which is a symptom of gastroesophageal reflux disease. Some content needs to be moved there: e.g. the disease is treated, not the symptom: treatment involves making a diagnosis and then treating the cause.--Steven Fruitsmaak (Reply) 16:40, 9 November 2006 (UTC)

 * Keep it separate. Heartburn is the most commonly used name, and even if it is a symptom of a technical disease, the symptom is so well-known as to deserve its own article. 129.98.212.164 17:49, 13 November 2006 (UTC)
 * Merge it because that will reduce duplication and increase clarity, but the combined article MUST have a section with a discussion of non-Gerd heartburn (i.e., heart attacks) and this really needs to be referenced in the first paragraph of the combined article.
 * Keep it separate. Like Bellamorbida below, hearburn is not GERD and GERD is not heartburn. Cburnett 20:40, 25 November 2006 (UTC)
 * Heartburn is a symptom - GERD a disease => dont merge.
 * Keep it separate. Our daughter has reflux and none of the professional's have ever mentioned heartburn. --JimmyTheWig 14:08, 11 December 2006 (UTC)
 * Keep it separate. I have heartburn and have never had GERD.
 * Keep it separate. And, for that matter, Acid Reflux should be a separate entry as well. If we merge everything that's related to everything else, Wikipedia will only have one very long entry in it. Heartburn and Acid Reflux are possible symptoms of GERD. Both can occur for other reasons, including eating spicy food. Heartburn and Acid Reflux are related to each other but they are not the same thing. People can have GERD and not experience heartburn. Treatment for non-GERD Acid Reflux and non-GERD Heartburn are not the same as treatment for GERD. I, for one, hate it when I look in Wikipedia for some information and get redirected to some page which is not about what I am looking for and sometimes doesn't even mention the subject. If cross-references are needed, let's put them in.
 * Keep it separate. ''Heartburn should NOT merge with Gerd or vice versa.

Merge?
I agree with all,Heartburn MUST not be confused with GERD,as GERD is a serious medical problem which can lead to choking and death,along with the usual sysmtoms of repeated burning of the esophagus,which if nor treated over time may cause Barrets esophagus and/or cancer.

Heartburn is usaually a sympton of over indulgence of rich food etc,and happens to a person on a realatively occasions basis,not constantly everyday.

NO it should not be merged with the trifling but annoying heartburn with the serious condition of reflux disease,S.W.R

Heartburn should not be merged with GERD as GERD is a more serious condition that generally requires some form of medical treatment or the condition will worsen and can cause permanent damage to the esophogus. Although Heart burn is a sign and/or symptom of GERD, people with heartburn may not always have GERD; and thus do not need to be overconcerned they have some serious medical condition. Bellamorbida 20:08, 16 November 2006 (UTC)

 * Heartburn is actually a sufficient symptom to diagnose GERD.-- Doc James (talk · contribs · email) 18:03, 20 January 2009 (UTC)

 * "Heartburn" is not. Many people that are nowhere near consideration for GERD experience heartburn. A certain degree of frequency would be necessary (ie. "often" is sufficient). Maybe I'm just being picky with your language, but it is definitely very important to note that one case of heartburn is not sufficient. By the way, I agree that a merge is a bad idea, it would be like merging "headache" with "brain tumor." Perhaps "frequent headaches" is not sufficient to diagnose a brain tumor, but I'm sure you can understand where I'm coming from.  Anonabyss  [ Talk ] [ Contribs ] 19:58, 19 February 2009 (UTC)

Water treatment
Someone claimed that logically, water cannot reduce heartburn because of the logarithmic nature of the pH system requiring 10 times the volume of acid to neutralize the pH by one point. This may seem logical, but it is not for certain just off that logic (consider that the volume of acid is not that great in the space of an esophogus. That comment should not be there without a reference. Ichibani 02:37, 19 November 2006 (UTC)

I agree with the above statement. I've had heartburn on numerous occasions when drinking a glass of water did help relieve the effects to an extent. Since the comment only pertains to temporary relief, I think it is useful and should remain.
 * Water may not significantly change the PH level of the stomach, but it can rinse the acid back out of the esophagus, and back into the stomach where it belongs. The amount of acid in the esophagus which is causing the heartburn is probably only a small amount.--RLent 23:33, 16 January 2007 (UTC)

A source would be good. Not to doubt your experience or anyone else's, but it's hardly scientific. Keeping encyclopedia pages about medical conditions focused on verifiable fact is probably a good call. Ichibani 06:58, 17 January 2007 (UTC)

I disagree, For me water dose not work due to severe GERD. The acid rises into the esophagus water May be temporary relief but adding more contents to your stomach can just make it worse

 * I would have to disagree with the notion that water might be helpful in treating heartburn, based on my personal experience. In almost all of cases, my heartburn gets worse if I drink a few glasses of water. I suppose this is due to the fact that it becomes easier for the stomach acid
 * to reach esophagus because of increased gastric valume due to water intake (and also because water apparently does not reduce stomach acidity). 193.217.55.223 03:58, 19 July 2007 (UTC)

There's no source for water treatment. We're not experts and even if we were, it'd be original research to decide whether or not water can help. Considering no advice is better than bad advice, I removed it. If someone brings up a source either way (saying water helps, hurts, or even does nothing) we should definitely add it. Ichibani utc 04:41, 19 July 2007 (UTC)

Folk Remedies
I removed a collection of folk remedies that were added to the article. An encyclopedia article should not serve as a list of possible treatments that have been suggested. Ichibani 22:03, 29 April 2007 (UTC)

 * of course it should
 * wikipedia is the also the repository of common wisdom
 * if were untrue then yes it should be deleted
 * I read an item today (6 Feb 2008) which was just deleted and thought :it was:
 * well identified as advice from your grandmother
 * pertinent to the problem which has know cause nor cure
 * logically argued
 * I think it is cruel to only list what is on pharmacutical websites
 * is only foolishly pushing big pharma,and worse in the long run will cheapen wikipededia which most people trust to tells the truth
 * Finally, recommending to drink more water seemed to answer correctlyearlier questions discussed here
 * -- 88.169.28.67 (talk) 21:58, 6 February 2008 (UTC)

 * WP:NOT -- Zsero (talk) 22:02, 6 February 2008 (UTC)

 * Whether or not the remedies work, without a reference from a peer reviewed journal they are essentially useless. I
 * could say that sand cures tiger bites, because my grandmother told me it did. That doesn't make it wworthy of being
 * on wikipedia 88.106.82.168 (talk) 00:01, 23 October 2008 (UTC)

Information resource
Please consider adding the National Heartburn Alliance (www.heartburnalliance.org) to your content references and/or the list of resources linked. The site contains a wealth of information written and edited by published academics who are leaders in the GI field (see "about the Board" for information). The site is referenced by the National Institutes of Health online. The site does not link to product sites, but does contain online screener tools that can direct sufferers to the appropriate lifestyle changes and medication options based on the frequency and severity of their symptoms. The site does not contain information on GERD. While I know Wikipedia isn't meant to be a clearinghouse for web links, I believe readers will find the information listed on the site to be helpful. Thank you for considering this information source. Feel free to e-mail us at nhbainformation@heartburnalliance.org for more info or to speak with any of the Board members. —The preceding unsigned comment was added by 63.115.255.28 (talk • contribs).

Diagnosis
Because the symptoms of angina might mimic those of indigestion, perhaps the focus of diagnosis should be to rule out cardiac causes of the symptoms, rather than to confirm heartburn?

____________________________________

69.140.152.55 (talk) 14:12, 31 May 2008 (UTC)

Please improve article!
This article desperately needs:
 * a diagram showing where heartburn typically and atypically occurs, superposed on a male and female chest
 * a clearer description of what heartburn feels like -- and entire section dedicated to describing it and showing what's going on from an anatomical point of view with pictures —Preceding unsigned comment added by 18.187.0.86 (talk) 21:51, 4 July 2008 (UTC)

Merge
Have suggested we merge this article with GERD. -- Doc James (talk · contribs · email) 18:21, 20 January 2009 (UTC)

 * Have realized that merging is a bad idea. Heartburn is a symptom,  GERD is a disease.  Page needs to be written to reflect this. Doc James  (talk · contribs · email) 23:05, 20 April 2010 (UTC)

Addition of unsourced or poorly sourced claims
The following (almost verbatim) has been inserted into the article a total of seven times over the past three months:

"Popular natural remedies include aloe vera juice, apple cider vinegar, and marshmallow root tea."

Sometimes the text is sourced to altmedicine.about.com (not a good source for a medical article, per WP:MEDRS), and sometimes it is completely unsourced. Each addition has been made by the same editor - User:Sdm9093. I have reverted these additions, with my edit summaries indicating the lack of reliable (or, in some cases, any) sources. The edits adding the text back have generally been without edit summaries. Since the pace of these additions has now stepped up (there have been two today), I thought it best to discuss here.

Unsourced or poorly sourced claims should not be added to this (or any) article. If there's a reason why this text is repeatedly added back with no commentary or discussion, now would be a good time to discuss.

So, what's the rationale for why this should be included? Is the only source altmedicine.about.com? If so, why do you feel that is a reliable source for a medical article, given both the policies at WP:RS and the guidelines at WP:MEDRS which seem to say otherwise? --  Transity (talk • contribs) 19:07, 22 September 2009 (UTC)

 * It appears that User:Sdm9093 has now added the same text back as an IP user User:64.62.15.158. Again, I urge you to discuss this instead of edit warring. --  Transity (talk • contribs) 20:03, 22 September 2009 (UTC)

 * I'll go ahead and remove it again, then. If you want to re-add it, please discuss here before doing so. Thanks. --  Transity (talk • contribs) 13:01, 25 September 2009 (UTC)

Gastric reflux should redirect here
Gastric reflux should redirect here rather than to the chronic disease. —Preceding unsigned comment added by Kadhumia flo (talk • contribs) 14:33, 23 November 2009 (UTC)

 * Gastric reflux is a disease this is about a symptom. Doc James (talk · contribs · email) 23:06, 20 April 2010 (UTC)

Rewrite
This page needs to be rewritten. It is presented as a disease rather than as a symptom. Heart burn can sometime represent an MI at which antacids are not the best treatment. GERD is the disease. Heart burn is a type of chest pain. Will work on conveying this distinction over the next week or so. Doc James (talk · contribs · email) 22:35, 20 April 2010 (UTC)

I agree that this page needs to be rewritten. I am going to begin working on this article. I welcome your help with this. CheckDO (talk) 04:13, 18 November 2021 (UTC)

How should we organize this topic area?
This is complicated. 90% of the literature using heart burn interchangeably with GERD. I feel that we should keep them seperate with this being the symptom the other being the disease. This however makes finding good references hard. Doc James (talk · contribs · email) 03:52, 21 April 2010 (UTC)

External Review Comments
The following comments are from an external reviewer BSW-RMH as part of the new joint Wikipedia talk:WikiProject Medicine/Google Project.

Hello Heartburn article writers and editors, This article currently has 'start' status and is a high priority article for the Wikipedia talk:WikiProject Medicine/Google Project. Expansion of this article is seriously hampered by confusion over the definition of the term 'heartburn'. I suggest agreeing on a definition and then expanding the article. Throughout this review I will be using heartburn as meaning the burning sensation in the chest due to acid reflux, because this is the most common meaning of the term in the clinical GI field. Specific suggestions are as follows:

Images
As previously mentioned by others on this page, this article would definitely benefit from the addition of images. Sources for possible images to include are listed here. As far as I can tell, these are in the public domain and do not have copyright restrictions, but someone with more experience in that area should confirm this before adding them to the article.
 * http://www.megahowto.com/wp-content/uploads/2010/02/Heartburn.gif
 * http://treatheartburn.org/wp-content/uploads/2009/09/Cause-of-Heartburn.jpg
 * http://www.riversideonline.com/source/images/image_popup/r7_heartburn.jpg

BSW-RMH (talk) 15:52, 18 May 2010 (UTC)

 * All of these images pertain to gastric reflux. This is about a symptoms that is not necessarily cause by reflux this I do not think these images are appropriate.  Doc James  (talk · contribs · email) 16:47, 18 May 2010 (UTC)

 * Heartburn is the burning chest pain most commonly caused by gastric reflux. With that note, they seem apprpriate to me. Do you have other suggestions of images?BSW-RMH (talk) 16:56, 18 May 2010 (UTC)

 * Heartburn is the burning sensation in the chest not nessacarily cause by gastric reflux. This paper states "Atypical symptoms such as heartburn, dull pain, and fatigue or symptoms that were intermittent in nature increased delay time" to be seen for an MI.    Thus it is a symptoms and there are other causes other than gastric reflux.  Doc James  (talk · contribs · email) 17:04, 18 May 2010 (UTC)

 * Right, I revised that comment to say it is the most common cause. There are other less common cause, perhaps, but then again it may be a matter of opinion if the chest pains associated with non-gastric reflux causes would be necessarily be categorized as 'heartburn'. I'll try to find some primary research references that resolve this issue for us. BSW-RMH (talk) 17:09, 18 May 2010 (UTC)

 * WebMD's site on heartburn is well-worded in regards to the issue of differentiating heartburn and the chest pain associated with MI. (http://www.webmd.com/heartburn-gerd/tc/heartburn-topic-overview) We are going to be hard-pressed to find primary research articles discussing the sematics of the term 'heartburn'. BSW-RMH (talk) 21:23, 18 May 2010 (UTC)

Merging
I recommend against merging with GERD, which is a frequent topic of discussion for this article. GERD is the frequent or chronic occurence of heartburn due to gastric reflux that can lead to serious complications and is characterized by esophageal erosion. One can experience heartburn without having GERD. This is well-phrased by the Mayo Clinic page of heartburn, "Heartburn that occurs frequently and interferes with your routine is considered gastroesophageal reflux disease (GERD)."
 * http://www.mayoclinic.com/health/heartburn-gerd/DS00095/DSECTION=complications

BSW-RMH (talk) 15:52, 18 May 2010 (UTC)

 * Would prefer to stick with peer reviewed review articles rather than using the mayo clinic which is not necessarily evidence based or peer reviewed. Doc James (talk · contribs · email) 16:48, 18 May 2010 (UTC)

 * The Mayo clinic is a reliable source of basic medical information such as signs and symptoms, as is MedlinePlus. I will add some additional textbook sources as time permits, or perhaps you can recommend some. BSW-RMH (talk) 16:59, 18 May 2010 (UTC)

Definition
This section needs to be rewritten based on editor consensus. I recommend that the definition be written as follows to focus on the most common usage of this term (for the public and for gastroenterology clinicians and researchers) to mean a burning sensation in the chest caused by reflux of stomach acid into the esophagus, with mention of other uses. Other uses include referring non-specfically to any burning sensation in the chest, which may be experienced or reported by patients experiencing chest pain caused by other conditions such as heart attacks and and other acute coronary syndromes, gall stone attacks, esophageal attacks. BSW-RMH (talk) 18:07, 18 May 2010 (UTC)

Suggested rewriting of this section:

Heartburn is the burning sensation in the chest commonly caused by digestive stomach acid backing up into the esophagus. The terms dyspepsia (or indigestion) are often used interchangeably with heartburn with dyspepsia being defined as indigestion commonly causing a combination of epigastric pain and heartburn. Chest pain with a burning sensation may also be referred to as 'heartburn' by people experiencing heart attacks or other acute heart syndromes, gallstone attacks, or esophageal spasms.

BSW-RMH (talk) 18:07, 18 May 2010 (UTC)

Differential Diagnosis
Rewritten. BSW-RMH (talk) 17:00, 18 May 2010 (UTC)

Changes may have been changed or reverted and will be reposted here for consideration:

Chest pain can be caused by several conditions and a preliminary diagnosis of heartburn is based on additional signs and symptoms. The chest pain caused by heartburn 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 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. If the chest pain is suspected to be heartburn, patients may undergo an 'Upper GI series' to confirm the presence of acid reflux.

In the absence of these other signs and symptoms associated with heartburn, other signs and symptoms may indicate that the burning chest pain is associated with other disorders. For example, severe, crushing or burning chest pain combined with difficulty breathing or jaw or arm pain are symptoms of an acute myocardial infarction and angina. . Burning chest pain combined with back pain, shoulder pain, fever, jaundice, or nausea may indicate a gall bladder attack caused by gallstones. . Burning chest pain after eating or drinking and combined with difficulty swallowing may indicate esophageal spasms.

It may be good to put a special WARNING, about the danger of mistaking chest pain associated with a heart attack or other serious heart condition for gastrointestinal heartburn.

BSW-RMH (talk) 18:07, 18 May 2010 (UTC)

Diagnostic approach
An expanded summary of an Upper GI Series would be useful. BSW-RMH (talk) 19:35, 18 May 2010 (UTC)

Treatment
This section also requires expansion, again I recommend from the perspective that heartburn is being used to refer to chest pain being caused by gastric reflux. However, mention will need to be made of NERD which does not respond to PPI or other medication commonly used to treat GERD. Perhaps this is best presented a summary and linking to the more comprehensive article on GERD, however that article does not cover NERD or functional heartburn treatment options. (2010);26(4):759-65. PMID: 20095795
 * Mayo Heartburn Treatment page (http://www.mayoclinic.com/health/heartburn-gerd/DS00095/DSECTION=treatments-and-drugs)
 * Modlin et al. Diagnosis and Management of Non-erosive reflux disease-The Vevey NERD consensus group. Digestion (2009);80:74-88.
 * Anderson, K. Gastroesophageal Reflux Disease. Radiol Technol (2010);81:251-268.
 * Kushner PR. Curr Med Res Opin. Role of the primary care provider in the diagnosis and management of heartburn.

BSW-RMH (talk) 19:35, 18 May 2010 (UTC)

 * It now covers function heartburn. More indepth treatment discussion belong on the subpages.  NERD is a subtype of GERD and would be dealt with on that page. Doc James  (talk · contribs · email) 19:58, 18 May 2010 (UTC)

 * I do not have access to the full text of PMID: 20095795 could you send me a copy? Thanks -- Doc James  (talk · contribs · email) 20:05, 18 May 2010 (UTC)

 * Yes, but I will have to scan it in so give me a little while-I only have access to the hard copy. I think you may want to read a bit more before making changes associated with these terms. NERD isn't a a subtype of GERD. And the concept of Functional heartburn (FH) is by no means a consensus in the GI field.
 * Hershcovici T, Fass R. GERD: are functional heartburn and functional dyspepsia one disorder? Nat Rev Gastroenterol Hepatol. (2010);7(2):71-2. PMID: 20134484
 * Modlin et al. Diagnosis and Management of Non-erosive reflux disease-The Vevey NERD consensus group. Digestion (2009);80:74-88.

 * BSW-RMH (talk) 20:38, 18 May 2010 (UTC)

Heart burn
Before we move forwards we must come to a conclusion regarding how we are going to use the term heartburn. This paper describes it as a typical symptom of an MI "other typical symptoms, including shortness of breath, nausea and vomiting, sweating, epigastric pain, abdominal pain or heartburn, and neck or shoulder pain (15%)"  Even though many source use it synonymously with GERD / gastritis this is not the case with the best sources. Doc James (talk · contribs · email) 17:10, 18 May 2010 (UTC)
 * There are always going to be primary research articles from individudal research groups using different terms different ways, sometimes in error, and not necessarily in reflection of clinical consensus-what we need to use as sources are references representing the majority consensus of a particular field, which may change and need to be updated over time. If possible, I would like to finish my review and then continue with discussion of this issue on my own time-or the review may not get finished. I will not make any direct edits during the review process and just post suggested re-writing here in consideration of your concerns. BSW-RMH (talk) 17:18, 18 May 2010 (UTC)
 * The is lots of evidence and plenty of reviews to support the assertion that heartburn is a symptoms that most commonly represents GERD but frequently represents ACS / MI. They teach this to everyone in medical school.  A large portion of the general population realize that heartburn is a symptom of MI per "Given that one of the most powerful predictors of knowledge in our sample was sex, with women significantly more likely to have a score of at least 70% on the Knowledge Scale than men (odds ratio, 1.77; P < .001), we further examined differences between men and women in cardiac knowledge. Overall knowledge scores were higher for women than men (73% vs 70%). Women more accurately identified less-typical symptoms of AMI than men (back pain, jaw pain, heartburn, nausea, and neck pain)." from .  Sometimes the mayo clinic get it wrong.  Doc James  (talk · contribs · email) 17:25, 18 May 2010 (UTC)

 * By the way Uptodate has this too say in describing MI pain "Quality of the pain — The patient with myocardial ischemia often denies feeling chest "pain." More typical descriptions include squeezing, tightness, pressure, constriction, strangling, burning, heart burn, fullness in the chest, a band-like sensation, knot in the center of the chest, lump in the throat, ache, heavy weight on chest (elephant sitting on chest), like a bra too tight, and toothache (when there is radiation to the lower jaw)."  Doc James  (talk · contribs · email) 17:29, 18 May 2010 (UTC)

 * I appreciate you are concerned about this topic but I keep losing edits because you are updating this page so frequently. Can we address this issue when the external review is finished? BSW-RMH (talk) 17:33, 18 May 2010 (UTC)

Doc James (talk · contribs · email)  kindly moved this discussion to another page during the review process. It is reproduced here for further consdieration: BSW-RMH (talk) 20:15, 18 May 2010 (UTC)
 * Hi there, I've started copying to the clip board now :) I also try to hit preview often as this saves changes in a recoverable way too. OK, so I revised the edit to try to explain how I am approaching this. I am going to just use common terms here-to reflect the audience we are writing for. I appreciate fully your perspective and I've thought about this in detail. For me it comes down to writing for the Wikipedia audience. My recommendation for the definition is not to define heartburn as symptom but to define it as a symptom/condition/disease caused by acid backing up into the esophagus. The symptom you are calling heartburn I proposed to call a burning sensation in the chest. Here's my reasoning: that is the way the general public would most commonly define those two situations (as well as gastroenterologists). I do recognize that some lay people, and emergency docs as you mentioned, also use 'heartburn' to refer to any burning sensation in the chest AND that these different causes of burning sensations in the chest can be easily confused by patients if the pain is not severe, which should be noted in the definition section, but I don't think that is the most common definition. I think this makes the most sense, and is the most in line with the purpose of Wikipedia. I'll leave the recommendation on the talk page though so editors can hash it out and reach consensus on whether to define it as a 'symptom' or a 'symptom/conditon/disease'. BSW-RMH (talk) 18:43, 18 May 2010 (UTC)

 * Wikipedia has a policy to deal with naming issues for medical articles Manual of Style (medicine-related articles) which stipulates that we us technical terms in a technical sense. Gastroenterologist BTW do not usually use the term "heartburn" to describe a disease but the more specific terms GERD, functional heartburn, etc. I agree that the lay press does use heartburn to indicate GERD but we cannot us it in this sense as 1) we already have a page on this topic so this would be a cotract 2) it would become to complicated we a mix of technical and nontechnical terms. Doc James  (talk · contribs · email) 19:21, 18 May 2010 (UTC)

 * I also agree that scientific intitutions such as the mayo clinic when writing for the lay public use heartburn as a synonym for GERD. I think this is poor practice but it is what it is. Doc James  (talk · contribs · email) 19:23, 18 May 2010 (UTC)

 * Let me be clear: I am not using or recommending using GERD as synonymous with gastric reflux. GI clinicians commonly use heartburn to refer to the pain caused by gastric reflux in general, not just GERD. GERD is a very specific disease/condition/disorder and rightly should have it's own article. Any gastroenterologists out there that can weight on this discussion?-I'll try to locate one to get on here. Meanwhile here's a list of publications supporting this terminology in common use by clinicians.BSW-RMH (talk) 20:10, 18 May 2010 (UTC)
 * Fass R, Sifrim D. Management of heartburn not responding to proton pump inhibitors. Gut. 2009 Feb;58(2):295-309.
 * Dowswell T, Neilson JP. Interventions for heartburn in pregnancy. Cochrane Database Syst Rev. 2008 Oct 8;(4):CD007065.PMID: 18843742
 * Ang D, Sifrim D, Tack J.Mechanisms of heartburn. Nat Clin Pract Gastroenterol Hepatol. 2008 Jul;5(7):383-92. PMID: 18542113

 * BSW-RMH (talk) 20:22, 18 May 2010 (UTC)

 * Yes all the above are good references. The Cochrane review describes it as a symptoms and I think that is were we should start.  I assume we can all agree that it is a symptom?  Symptoms than lead to a differential diagnosis. Doc James  (talk · contribs · email) 21:57, 18 May 2010 (UTC)

 * A symptom specifically referring the burning chest pain caused by acid reflux? :) Then yes, I agree. BSW-RMH (talk) 22:04, 18 May 2010 (UTC)

 * Than what would we call burning chest pain not caused by acid reflux? Doc James (talk · contribs · email) 22:08, 18 May 2010 (UTC)

 * 'burning chest pain' BSW-RMH (talk) 22:12, 18 May 2010 (UTC)

Other cause of heartburn
A few other cause of heartburn include function heartburn. Per uptodate "it is highly likely that functional heartburn represents a heterogeneous group of patients with different physiological mechanisms for their symptoms." ie not acid reflux related. Doc James (talk · contribs · email) 18:22, 18 May 2010 (UTC)

 * Functional heartburn (FH) refers to heartburn that does not respod to PPI or other heartburn-prevention medications. It is still not clear if FH represents a distinct condition were gastric reflux does not occur, or if it is just misdiagnosed NERD (heartburn caused by gastric reflux but without the esophageal erosion characteristic of GERD). BSW-RMH (talk) 18:52, 18 May 2010 (UTC)

It says that the cause is unknown which means that reflux has been ruled out. It is more than just heartburn that has not responded to PPIs even though it is the most common cause of non response. Thus one cannot say it is due to reflux. Here is the text from the 09 review.

"As a group, functional esophageal disorders are characterized by the presence of chronic symptoms attributed to the esophagus without evidence of structural or metabolic disorder. According to the Rome III criteria, patients should experience functional esophageal disorders for at least 3 months with symptom onset at least 6 months before diagnosis (Box 1).[4 ] Nonesophageal sources for symptoms should be excluded first before esophageal causes are entertained. Gastroesophageal reflux disease (GERD) and various esophageal motility disorders may be responsible for the spectrum of functional esophageal-related symptoms. Hence, it is imperative that these conditions be ruled out before a diagnosis of a functional esophageal disorder is established. Rome III also removed rumination syndrome from the functional esophageal disorder group and added it to the functional gastroduodenal disorders. Although the Rome project attempts to repeatedly update the diagnostic criteria of the different functional bowel disorders, the relatively high frequency (approximately every 5 years) of the meetings that are commonly associated with changes in diagnostic criteria may render past and ongoing studies in this field obsolete."

Doc James (talk · contribs · email) 19:10, 18 May 2010 (UTC)

 * This is all correct information. Let me try to clear this up. Heartburn (as I am recommending defining it and as it is used in the references we are discussing) is caused by acid backing up into the esophagus: this results from metabolic or functional disorders (GERD, NERD, etc.), OR from dyspepsia (upset stomach). Functional heartburn is a newer term that is still in debate as to whether it exists as a distinct disorder (right now it is classification of symptoms and negative diagnostic tests) or is misdiagnosed NERD (the reference you provided is the best evidence that it is not NERD) or misdiagnosed dyspepsia (the reference you provided does not control for this, see discussion in: Hershcovici T, Fass R. GERD: are functional heartburn and functional dyspepsia one disorder? Nat Rev Gastroenterol Hepatol. (2010);7(2):71-2. PMID: 20134484). Considering there is not yet a consensus in the field on the etiology of FH, I don't think we should include it yet. BSW-RMH (talk) 20:07, 18 May 2010 (UTC)

 * Neither gastitis, functional heartburn or myocardial ischemia are cause by acid backing up. GERD and NERD are yes but they are not functional disorders per the ROME 111 criteria. But let see what others think. Doc James  (talk · contribs · email) 21:50, 18 May 2010 (UTC)

 * Yes, please-more input needed-no progress can be made until a consensus is reached. BSW-RMH (talk) 22:11, 18 May 2010 (UTC)

As a medically-trained professional, I consider heartburn to be a syndrome, one cause of which is GERD; therefore, I endorse the sense of "heartburn" as a symptom caused by a constellation of mechanisms. As a person who searches WP for topics on which I'm not an expert, I would expect a commonly-used term to have a page that represents common usage, hence I again endorse a broad treatment of a term that is commonly used for a wide variety of ailments. -- Scray (talk) 02:30, 19 May 2010 (UTC)

The question
The question is should heart burn mean "burning in ones chest from any cause" or "burning in ones chest from acid reflux". Doc James (talk · contribs · email) 03:13, 19 May 2010 (UTC)

 * I don't know much about heartburn, but I'm tentatively with Scray: I think that 'any cause' is appropriate and likely to be what our readers expect to find on this page.  Acid reflux might be the most important cause (and therefore should dominate the page), but I wouldn't want to exclude at least a brief mention of other causes.  WhatamIdoing (talk) 03:38, 23 May 2010 (UTC)

 * Just a note: the article is currently written as 'heartburn the disease'-other causes of similar burning chest pain that can sometimes be mistaken for acid reflux (such as heart attack) are mentioned as sharing the symptom of burning chest pain. DocJames would like it rewritten as heartburn being a symptom of many diseases, rather than a disease itself. Perhaps there needs to be a disambiguation page for heartburn(disease) vs. heartburn(symptom)?BSW-RMH (talk) 14:43, 23 May 2010 (UTC)

 * I am not convinced that heartburn is a disease. It is a symptoms yes.  Diseases would include GERD, gastritis etc.  It is currently written as a symptom per WP:MEDMOS.  Further evidence to support my position include the ICD10 criteria  here which describes heart burn as a "Symptoms and signs involving the digestive system and abdomen" and not as a disease.  Doc James  (talk · contribs · email)

18:40, 23 May 2010 (UTC)

 * I agree with the perspectives of Scray and WhatamIdoing, which I will attempt to summarize here. It appears that the consensus is that most people will come to the page either looking for information on heartburn as a 'syndrome or condition' caused by gastric/acid reflux, a common meaning, OR information on the symptom of heartburn/burning chest pain. Thus the article should be written to cover all meanings, with a focus on the heartburn 'syndrome/condition' caused by gastric/acid reflux (GERD or indigestion etc.) being the most common cause of heartburn/burning chest pain. It appears that we now have three editors (BSW-RMH, Scray, WhatamIdoing) that support this consensus. Any clarifications? DocJames, how does this sound to you? It would great to move forward with the needed changes to get this article to GA status, because it is a high priority article. BSW-RMH (talk) 17:27, 26 May 2010 (UTC)

About 42% of the United States population have had heartburn at some point.
So what?

--178.108.246.141 (talk) 23:05, 30 March 2011 (UTC)

Statistics for other areas of the world would be helpful, if this section is not going to be deleted. 03jkeeley (talk) 14:01, 26 August 2013 (UTC)

Heartburn and dyspepsia
Or basically the same. Thus propose a merge. Doc James (talk · contribs · email) 23:59, 23 February 2015 (UTC)
 * Indigestion is wider term. Therefore remove this proposal. Doc James  (talk · contribs · email) 09:17, 21 June 2015 (UTC)
 * Not that I'm contributing anything here, but dyspepsia is abdominal pain and heartburn chest discomfort. The equivalent classic term for heartburn would be pyrosis -- Samir 05:43, 7 October 2015 (UTC)

"Agita" listed at Redirects for discussion
The redirect [//en.wikipedia.org/w/index.php?title=Agita&redirect=no Agita] has been listed at redirects for discussion to determine whether its use and function meets the redirect guidelines. Readers of this page are welcome to comment on this redirect at  until a consensus is reached. WP scatter t/c 20:35, 28 May 2023 (UTC)

Wiki Education assignment: PHMD 2040 Service - Learning Fall 2023
— Assignment last updated by PharmD2026 (talk) 03:38, 14 April 2024 (UTC)

 * Hello,

I will be adding sources to a few areas that have [citation needed] and also some behavioral/lifestyle modifications --PharmD2026 (talk) 20:10, 14 April 2024 (UTC)

title: Talk:Heartburn


text:
Florida, Uruguay

Florida is the capital of Florida Department of Uruguay. Having a population of over 33,000, it is home to almost half of the inhabitants of the department.

Geography
It is located on Route 5, around 90 km north of Montevideo.

The stream Arroyo Santa Lucía Chico flows along the east and south limits of the city.

Climate
On 14 January 2022, Florida recorded a temperature of 44.0 C, which is the joint highest temperature (along with Paysandú) to have ever been recorded in Uruguay.

History
The city was founded on 24 April 1809 with this name, Florida, in honor of the count of Floridablanca, the prime minister of the Spanish crown. It had acquired the status of "Villa" (town) before the Independence of Uruguay. On 10 July 1856, it became capital city of the department by the Act of Ley Nº 493 and on 19 April 1894 its status was elevated to "Ciudad" (city) by the Act of Ley Nº 2.258.

It is home of the famous Piedra Alta de la Florida, the place of the Declaration of Independence in 1825. The city is also famous for San Cono's chapel, where multitudes gather every 3 June.

An important building is the Cathedral of Florida, which is the National Sanctuary of the Virgin of the Thirty-Three.

Population
In 2020, Florida had a population of 99,564. Source: Instituto Nacional de Estadística de Uruguay

Sister city
Florida has one sister city:

 * Asunción, Paraguay

Places of worship

 * Cathedral Sanctuary of Our Lady of the Thirty-Three (Roman Catholic)
 * St. Joseph Parish Church (Roman Catholic)
 * St. Thérèse of Lisieux Parish Church (Roman Catholic)
 * St. Conus Chapel in Florida, a very popular Roman Catholic pilgrimage sanctuary

title: Florida, Uruguay


text: User talk:69.63.0.104

title: User talk:69.63.0.104


text:
Rivera

Rivera is the capital of Rivera Department of Uruguay. The border with Brazil joins it with the Brazilian city of Santana do Livramento, which is only a block away from it, at the north end of Route 5. Together, they form an urban area of around 200,000 inhabitants. As of the census of 2011, it is the sixth most populated city of Uruguay.

History
On 21 March 1860 a pueblo (village) named Pereira was created by the Act of Ley Nº 614.

On 7 May 1862, it was substituted by the villa (town) named Ceballos and founded by the Act of Ley Nº 704, in honour of the Spanish viceroy Pedro de Cevallos. In July 1867 it took on the official name Rivera and was recognized as a villa. The Brazilian town Santana do Livramento already existed just across the border. On 1 October 1884, it became capital of the Department of Rivera by the Act of Ley Nº 1.757. Its status was elevated to ciudad (city) on 10 June 1912 by the Act of Ley Nº 4.006.

In 1943, the Plaza Internacional Rivera-Livramento (see photo) was built to celebrate the Fifth Conference of the Commission Mixta for Mixed Limits and as a hope for the future integration of the two towns, claimed to be the only international square in the world. From 1851 to this day, inhabitants of both communities are free to move in both sides. Today, duty-free shops are one of the main economic resources of Rivera.

The first inhabitants of the city were Spaniards, Italians, Portuguese and some Brazilians immigrants who lived in Santana do Livramento, on the Brazilian side of the border.

Border control
The two cities of Rivera (Uruguay) and Santana do Livramento (Brazil) maintain an open border without any physical border barriers or checkpoints. Inhabitants of the twin cities are free to move anywhere within the two communities without having to undergo checks.

Travellers crossing the border here and proceeding further into the other country are required to complete border formalities at an integrated border control post located at Siñeriz Shopping in Rivera. The integrated border control post housing the immigration and customs offices of both countries was inaugurated on 28 December 2016. Previously, travellers had to visit various offices located in different parts of the twin cities.

Economy
One of the main economic activities of the city of Rivera is the duty free stores. These are aimed at Brazilian neighbors, mainly coming from the cities of Rio Grande do Sul, near the border with Uruguay. The close proximity of Rivera makes it a popular destination for buying imported dollar products. With the fall in the price of the US currency, many devices can be bought for prices up to 40% less than similar ones sold in Brazil. The Rivera shopping limit is $300 per person. Purchases above this amount must be declared at the Federal Revenue Office for the payment of the corresponding import tax so that the product can legally enter Brazil.

There is also a casino, located on one of the avenues where the border between the two countries runs. Within the department, livestock farming, agriculture and afforestation predominate.

Population
In 2011, Rivera had a population of 64,465 Source: Instituto Nacional de Estadística de Uruguay

Climate
The climate in Rivera, as well as in Santana do Livramento, is humid subtropical (Cfa, according to the Köppen climate classification), temperate in the winter and relatively hot in the summer.

Places of worship

 * Church of the Immaculate Conception (Roman Catholic)
 * Parish Church of St. Dominic (Roman Catholic)
 * Parish Church of the Sacred Heart (Roman Catholic)
 * St. Peter Parish Church (Roman Catholic)

Consular representation
Brazil has a Consulate-Geral in Rivera, located at 1159 Calle Ceballos.

Notable people

 * Ronald Araújo, professional footballer for FC Barcelona, was born in Rivera.
 * Luiz Eduardo Garagorri, professional mixed martial artist, currently signed for UFC.
 * Aparicio Méndez, from Rivera, was President of Uruguay from 1976 to 1981. He was never elected democratically and was chosen by the military dictatorship.
 * Rodrigo Mora, professional footballer for Club Atlético River Plate, was born in Rivera.
 * Sebastián Puchetta, professional footballer, born in Rivera.

Transportation
There are regular bus services to Montevideo. A rail service to Tacuarembó has been run intermittently.

Rivera is served by Pres. Gral. Óscar D. Gestido International Airport. On August 14, 2023 Uruguay and Brazil signed an agreement to internationalize the airport. According to this agreement, as a binational facility, flights originated in Brazil are treated as domestic, even though the facility is in Uruguayan territory.

Sports
The Estadio Atilio Paiva Olivera holds 27,115 people and was used in the 1995 Copa América.

The Skatepark of Rivera is on Presidente Viera Street.

Twin towns – sister cities
Rivera is twinned with:
 * Santana do Livramento, Rio Grande do Sul, Brazil
 * Uruguaiana, Rio Grande do Sul, Brazil

title: Rivera


text:
User talk:Aanylpane

Please stop. If you continue to vandalize pages, you will be blocked from editing Wikipedia. - MordredKLB 21:12, July 13, 2005 (UTC)

title: User talk:Aanylpane


text:
Rivera Department

Rivera Department is a department of the northern region of Uruguay. It has an area of 9370 km2 and a population of 103,493. Its capital is the city of Rivera. It borders Brazil to the north and east, Cerro Largo Department to the southeast, Tacuarembó Department to the south and west and Salto Department to the northwest.

History
The first division of the Republic in six departments happened in 1816. Two more departments were formed later that year. At that time, Paysandú Department included all the territory north of the Río Negro, which included the present-day departments of Artigas, Rivera, Tacuarembó, Salto, Paysandú and Río Negro. On 17 June 1837 a new division of Uruguay was made and this territory was divided in three parts. In the new division, the Tacuarembó Department included also the present department of Rivera, until it was split from it in 1884.

On 7 May 1862 the village Pueblo de Ceballos was created, in honour of the Spanish viceroy Pedro de Cevallos. In July 1867 it took on the official name "Rivera". The Brazilian town Santana do Livramento already existed just across the border. On 1 October 1884, it became capital of the newly formed Department of Rivera by the Act of Ley Nº 1.757.

Geography
Along the eastern borders of the department with Cerro Largo Department flows Río Negro, with its tributaries flowing through the easternmost part of the department. From north to south, these are: Arroyo San Luis, which forms part of its border with Brazil, Arroyo del Hospital with its tributary Arroyo Blanco and Arroyo Ceibal.

The western part of its southern border with Tacuarembó Department is formed by Río Tacuarembó, with its tributaries flowing through most of the department. From west to east, these are: Arroyo Rubio Chico, Arroyo Laureles which also forms part of the southern border of the department, Arroyo Cuñapirú with its tributaries Arroyo Batoví, Arroyo Mangueras, Arroyo de los Médanos, Arroyo Corrales and Arroyo Zapucay, Arroyo Yaguarí with its tributary Arroyo Carpintería, and Arroyo Caraguatá with its tributary Arroyo Coronilla.

At the northwest end of the department reaches the hill range Cuchilla de Haedo from the south turning into the Cuchilla Negra hill range, with the hill Cerro de los Peludos between them. Along the borders with Brazil, to the north, runs the hill range Cuchilla de Santa Ana. In the middle of the department is the hill Cerro de la Cruz, while on its eastern end are the hills Cerro del Hospital and Cerro Bonito.

Demographics
As of the census of 2011, Rivera Department has a population of 103,493 (50.397 male and 53.096 female) and 39,859 households.

Demographic data for Rivera Department in 2010: 2010 Data Source:
 * Population growth rate: 0.610%
 * Birth Rate: 16.45 births/1,000 people
 * Death Rate: 7.80 deaths/1,000 people
 * Average age: 30.8 (28.9 male, 32.4 female)
 * Life Expectancy at Birth:
 * Total population: 76.12 years
 * Male: 72.85 years
 * Female: 79.89 years
 * Average per household income: 22,084 pesos/month
 * Urban per capita income: 8,806 pesos/month

Transportation
Route 5 joins Rivera, the capital of the department in the northwest, with Tranqueras and then with all the capitals of the departments to its south, Tacuarembó, Durazno, Florida and Canelones, reaching Montevideo from the west. Route 6 joins Vichadero, in the southeast of the department, with some important cities of the same departments to the south, including Sarandí del Yí and San Ramón, reaching Montevideo from the north. Between Rivera and Vichadero runs Route 27, while Route 30 joins Tranqueras with the city of Artigas to the northwest. Route 44, which marks part of the southern border of the department, connects with Melo to the southeast. Routes 28 and 29 connect the town Minas de Corrales with the other main Routes of the department.

The railroad track Montevideo-Rivera is active for cargo trains of the Línea Rivera, which connects with the railroad infrastructure of Brazil. A small length of this track, from Montevideo to Florida only, is also active for passenger trains.

The small airport of the city of Rivera receives light aircraft and an irregular service by a Brazilian airline to Porto Alegre.

Visitors attractions

 * Parque Internacional between Brazil and Uruguay in the city of Rivera.
 * Minas de Corrales a town established in 1879, during the Gold Rush times.
 * Rincón de Tres Cerros near the border with Tacuarembó Department, approx. 15 km west of Minas de Corrales.
 * Valle del Lunarejo running parallel to Route 30, between Masoller and Tranqueras.

title: Rivera Department