Document Detail


How well do general practitioners manage dyspepsia?
MedLine Citation:
PMID:  2558205     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
This paper reports the incidence of dyspepsia in general practice, the characteristics of patients, the types of complaints presented and the management of the dyspeptic patient by general practitioners. Fourteen general practitioners in the Maastricht region of the Netherlands studied 318 consecutive patients presenting with dyspepsia. Two questionnaires were used: one filled in by the patient (82% response), the other by the physician (100% response). The diagnostic conclusions which were established after three months of follow-up were compared with the diagnostic hypotheses at the initial consultation. The annual consultation rate for dyspepsia was calculated as 27 per 1000 registered subjects. One third of the patients had an earlier history of dyspepsia. Almost all patients (95%) complained of pain, and 37% had been suffering from pain for more than three months before consulting the general practitioner. The general practitioner prescribed medication in 70% of cases; less commonly the patient was referred for x-ray (14%), endoscopy (13%) or to a specialist (11%). A higher age was associated with a higher probability of referral, and with the finding of organic disease. A history of ulcer disease was strongly correlated with the diagnosis of an ulcer during the current episode. The overall concordance between the general practitioner's diagnostic hypothesis at the initial consultation and the diagnostic conclusion after three months of follow-up was 78%; it was highest when minor pathology was suspected. We conclude that dyspepsia is managed well in general practice and is only rarely associated with major lesions. Dyspeptic patients referred to a specialist therefore constitute a highly selected population.
Authors:
D K Warndorff; J A Knottnerus; L G Huijnen; R Starmans
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The Journal of the Royal College of General Practitioners     Volume:  39     ISSN:  0035-8797     ISO Abbreviation:  J R Coll Gen Pract     Publication Date:  1989 Dec 
Date Detail:
Created Date:  1990-02-22     Completed Date:  1990-02-22     Revised Date:  2009-11-18    
Medline Journal Info:
Nlm Unique ID:  7503107     Medline TA:  J R Coll Gen Pract     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  499-502     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Duodenal Ulcer / complications,  diagnosis
Dyspepsia / complications,  etiology,  therapy*
Evaluation Studies as Topic
Female
Follow-Up Studies
Humans
Male
Middle Aged
Pain / etiology
Physicians, Family*
Predictive Value of Tests
Recurrence
Referral and Consultation
Stomach Ulcer / complications,  diagnosis
Time Factors
Comments/Corrections

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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