Rates of endoscopy and endoscopic findings among people with frequent symptoms of gastroesophageal reflux in the community.
BACKGROUND
Epidemiological studies have confirmed that gastroesophageal symptoms are highly prevalent. However, studies linking epidemiology with clinical or chart data are scarce. We aimed to determine the frequency of endoscopy and endoscopic findings, as well as predictors of health-care utilization, among people with reflux symptoms in the community.


METHODS
A previous survey of 2,118 Olmsted County, MN, residents in 1993 identified 242 subjects with frequent reflux symptoms (at least weekly) who received care at a medical center in the county. Data were abstracted from Mayo Clinic records between 1988 and 1998.


RESULTS
Overall, 130 of the 242 (54%, 95% CI 47-60%) had sought care for reflux. Twenty-five patients (10%) had visited a gastroenterologist; 47 (19%) had an upper endoscopy (EGD), 64 (26%) had an upper GI X-ray, and one had an ambulatory 24-h esophageal pH study. Long segment Barrett's esophagus was detected in 4 (9%) of those having an EGD and adenocarcinoma was found in one patient with Barrett's. Three patients had surgery for gastroesophageal reflux disease. Thirteen patients (5%) died, but no deaths were due to esophageal reflux or adenocarcinoma. Age, higher education, frequent heartburn, and dysphagia were all significant, independent predictors of consulting.


CONCLUSIONS
Although many people in the community have frequent reflux symptoms, few have investigations, and deaths were unrelated to reflux disease or its complications. Data from referral clinic or endoscopy series should not be extrapolated to the large numbers of people in the community with symptoms of reflux.
Division of Gastroenterology and Internal Medicine, Mayo Clinic College of Medicine, Rochester, Minnesota 55905, USA.
Sanjay
S
Nandurkar
G Richard
GR
Locke
Joseph A
JA
Murray
L Joseph
LJ
Melton
Alan R
AR
Zinsmeister
Ross
R
Dierkhising
Nicholas J
NJ
Talley
D000230:Adenocarcinoma / Q000473:pathology; D000328:Adult; D000368:Aged; D001471:Barrett Esophagus / Q000473:pathology; D016145:Endoscopy, Digestive System / Q000706:statistics & numerical data*; D004938:Esophageal Neoplasms / Q000473:pathology; D005260:Female; D005764:Gastroesophageal Reflux / Q000473:pathology* / Q000523:psychology / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D011795:Surveys and Questionnaires