Janssen H A, Borghouts J A, Muris J W, Metsemakers J F, Koes B W, Knottnerus J A
Department of General Practice, Maastricht University, The Netherlands.
Br J Gen Pract. 2000 May;50(454):375-9.
While chronic non-specific abdominal complaints are common in general practice, data on patients' perspective and management of these complaints are lacking. Knowledge of these data is important for the development of guidelines for management and assessment of the burden of chronic non-specific abdominal complaints on society.
To draw a comprehensive picture of chronic non-specific abdominal complaints in general practice, including volume, patients' perspective, and health care involvement.
In a retrospective study, 644 patients were selected in 16 general practices. Patients and general practitioners (GPs) received a questionnaire regarding the nature of complaints and health care management during the previous 12 months.
Overall, 619 questionnaires were returned and 291 patients participated. Of the study population, 15% of patients were diagnosed as suffering from non-ulcer dyspepsia, 39% from irritable bowel syndrome, and 45% from other abdominal complaints. Over 50% of patients suffered from chronic non-specific abdominal complaints on a daily or weekly basis. In these patients, general health perception is impaired and above norm scores on SCL-anxiety and SCL-depression scales were recorded. Only 4% of patients showed complete resolution of complaints during the previous 12 months. Fifty-two per cent of patients consulted their GP for abdominal complaints. Diagnostic modalities were used frequently. Medication was prescribed in 83% of patients with abdominal complaints. Twenty per cent of patients were referred to secondary or tertiary care. There was a considerable inter-doctor variation in the management of chronic non-specific abdominal complaints.
Once non-specific abdominal complaints have become chronic they are mainly managed by the GP. The impact on patients' physiological and psychological well being is large. Diagnostic and therapeutic modalities are frequently used. Given the considerable inter-doctor variation, research into the evidence base of management strategies is recommended.
虽然慢性非特异性腹部不适在普通医疗实践中很常见，但缺乏关于患者对这些不适的看法及处理的数据。了解这些数据对于制定慢性非特异性腹部不适的管理指南以及评估其对社会造成的负担非常重要。
全面了解普通医疗实践中慢性非特异性腹部不适的情况，包括数量、患者的看法以及医疗保健参与情况。
在一项回顾性研究中，从16家普通医疗机构中选取了644名患者。患者和全科医生（GP）收到了一份关于过去12个月内不适性质和医疗保健管理情况的问卷。
总体而言，共收回619份问卷，291名患者参与。在研究人群中，15%的患者被诊断为患有非溃疡性消化不良，39%患有肠易激综合征，45%患有其他腹部不适。超过50%的患者每天或每周都遭受慢性非特异性腹部不适的困扰。在这些患者中，总体健康感知受损，在症状自评量表焦虑和抑郁分量表上的得分高于正常水平。在过去12个月中，只有4%的患者症状完全缓解。52%的患者因腹部不适咨询过全科医生。诊断方式使用频繁。83%有腹部不适的患者被开了药。20%的患者被转诊至二级或三级医疗机构。在慢性非特异性腹部不适的管理方面，医生之间存在相当大的差异。
一旦非特异性腹部不适变为慢性，主要由全科医生进行管理。其对患者生理和心理健康的影响很大。诊断和治疗方式使用频繁。鉴于医生之间存在相当大的差异，建议对管理策略的证据基础进行研究。
