Investigation and therapy in patients with different types of dyspepsia: a 3 year follow-up study from general practice.
BACKGROUND
Decisions by GPs on investigation and treatment are based on the symptoms presented by the patient. The relevance of dyspepsia subgroups has been questioned, but their value in general practice has not been tested.


OBJECTIVE
The aim of this study was to investigate how dividing dyspepsia into different subgroups (ulcer-like, reflux-like, dysmotility-like, uncharacteristic and relapsing dyspepsia) affected the approach of GPs to patients with dyspeptic complaints.


METHODS
A random sample of GPs' patients consulting for different dyspepsia subtypes were studied by postal questionnaires 3 years after the initial consultation, obtaining information from the GPs' records on investigations, prescriptions of dyspepsia medication and gastrointestinal morbidity.


RESULTS
In the 3 years studied, 48% of the patients were prescribed dyspepsia medication, 14% were endoscoped and 3% were referred to a specialist. The dyspepsia subtype was significantly related to the type of drug prescribed, but not to investigations or referrals. Ulcer-like and reflux-like dyspepsia were treated in the same way.


CONCLUSIONS
Dyspepsia subtypes significantly influenced the treatment. Danish GPs treat all acid-related dyspepsia in the same way, and differently from other types of dyspepsia.
Meineche-Schmidt
V
V
Centre of Preventive Medicine, Glostrup University Hospital, Copenhagen, Denmark.
Jørgensen
T
T
D000328:Adult; D000368:Aged; D004415:Dyspepsia / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology; D016099:Endoscopy, Gastrointestinal; D005194:Family Practice; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D010818:Practice Patterns, Physicians'; D011446:Prospective Studies