Impact of referral for gastro-oesophageal reflux disease on the workload of an academic Gastroenterology Unit.
BACKGROUND
Gastro-oesophageal reflux disease is known to be a frequent cause of patients' referral to hospital gastroenterologists.


OBJECTIVE
To increase knowledge on referral for reflux disease, in an Italian academic setting.


METHODS
The impact of gastro-oesophageal reflux disease on 1 year's workload, comprising upper endoscopy, outpatients' consultations in the general clinic, oesophageal pH monitoring and oesophageal manometry was retrospectively assessed. Appropriateness of oesophageal pH monitoring and oesophageal manometry was also evaluated.


RESULTS
Endoscopy: Out of 2269 upper endoscopies reflux symptoms comprised 16.9% (n=386) of referrals; 19.1% only of these 386 patients had erosive oesophagitis at endoscopy and none had oesophagogastric malignancies (68% of the patients were >45 years). Consultations: Thirty-three percent out of 553 patients were referred for reflux symptoms. Upper endoscopy had already been performed before consultation in 64% of them. pH monitoring and oesophageal manometry: Two hundred and sixteen oesophageal pH monitorings and 160 oesophageal manometries were performed and 29% and 28%, respectively, were inappropriate, being performed in the diagnostic work-up of patients with typical reflux symptoms.


CONCLUSIONS
At an academic Gastroenterology Unit, (a) gastro-oesophageal reflux disease is a frequent referral for upper endoscopy and consultations, (b) prevalence of oesophagitis is low, (c) consultation is preceded by endoscopy in the majority of patients and (d) oesophageal pH monitoring and oesophageal manometry are often inappropriately used.
Cantù
P
P
Department of Medical Sciences, University of Milan, IRCCS Maggiore Hospital, Pad Granelli, Via F Sforza 35, 20122 Milan, Italy.
Savojardo
D
D
Carmagnola
S
S
Penagini
R
R
D000046:Academic Medical Centers; D016099:Endoscopy, Gastrointestinal / Q000706:statistics & numerical data; D050782:Esophageal pH Monitoring / Q000706:statistics & numerical data; D005762:Gastroenterology / Q000706:statistics & numerical data*; D005764:Gastroesophageal Reflux / Q000175:diagnosis* / Q000453:epidemiology / Q000473:pathology; D006757:Hospital Units / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D007558:Italy / Q000453:epidemiology; D008365:Manometry / Q000706:statistics & numerical data; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D016526:Workload / Q000706:statistics & numerical data*