Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands.
Eur J Gastroenterol Hepatol. 2010 May;22(5):578-82. doi: 10.1097/MEG.0b013e328335638c.
Only a minority of patients with gastro-oesophageal reflux symptoms (GORS) seek medical advice. Little is known about patient characteristics associated with consultation in primary care and referral to secondary care.
We compared the characteristics of patients with GORS in the general population, those who consulted their general practitioner (GP) and those referred to secondary care for upper endoscopy. We aimed to identify differences between patients with short term (<90 days) and chronic symptoms, and differences between patients with symptoms in primary and secondary care. The study was performed in a primary care based prospective dynamic population.
In total, 16% of 7237 adult patients were identified with GORS. Twenty-five percent of these patients consulted the GP, of whom 40% were referred for endoscopy. Patients with chronic GORS were older, had a higher body mass index, were more often referred for upper endoscopy (all P<0.001) and more frequently had relevant findings during endoscopy (oesophagitis: 50% and Barrett's oesophagus: 10%). Patients referred for upper endoscopy were older than nonreferred patients (P<0.001).
Only a minority of people with GORS visit their GP. After consulting referral for endoscopy occurs relatively often. Underlying endoscopic abnormalities are frequently found in patients with chronic GORS.
只有少数胃食管反流症状(GORS)患者寻求医疗建议。对于与初级保健咨询和二级保健转诊相关的患者特征知之甚少。
我们比较了普通人群中 GORS 患者、向全科医生(GP)咨询的患者和因上消化道内镜检查而转诊至二级保健的患者的特征。我们旨在确定短期(<90 天)和慢性症状患者之间的差异,以及初级保健和二级保健中症状患者之间的差异。该研究在基于初级保健的前瞻性动态人群中进行。
在总共 7237 名成年患者中,有 16%被确定为 GORS 患者。这些患者中有 25%向 GP 咨询,其中 40%被转诊进行内镜检查。慢性 GORS 患者年龄较大,体重指数较高,更常被转诊进行上消化道内镜检查(均 P<0.001),并且内镜检查中更常发现相关发现(食管炎:50%和 Barrett 食管:10%)。接受内镜检查转诊的患者比未接受转诊的患者年龄更大(P<0.001)。
只有少数 GORS 患者会去看他们的 GP。咨询后,进行内镜检查的转诊相对常见。慢性 GORS 患者常存在潜在的内镜下异常。