An international primary care survey of GERD terminology and guidelines.
BACKGROUND
Terminology used to describe upper gastrointestinal disorders differs by country and language. However, the extent of variation in physician understanding of GERD and associated conditions and symptoms is not known.


OBJECTIVE
To determine the knowledge of primary care physicians with regard to: terminology related to GERD, their understanding of related complications and extra-esophageal symptoms/conditions, and their use of guidelines relating to GERD.


METHODS
Gastroenterologists from 17 countries asked primary care physician colleagues to complete a one-page online survey on GERD.


RESULTS
352 primary care physicians, (77% community-based, 23% hospital-based) completed the questionnaire. Gastroesophageal reflux disease/GERD (84%) or reflux/reflux disease (47%) were the terms mostly often used to record a diagnosis for patients with reflux-related symptoms or clinical manifestations; dyspepsia (15%), epigastric pain (10%), and gastritis (9%) were infrequently used. Erosive esophagitis, Barrett's esophagus, stricture, and esophageal adenocarcinoma were recognized as being associated with GERD by 88, 71, 61 and 51% of physicians, respectively. Extra-esophageal problems of cough, sleep-related disorders, laryngitis and asthma were recognized to be associated with GERD by 74, 50, 48 and 47% of respondents. Thirty-nine percent of physicians stated that they did not use a specific definition of GERD; 33% used an international and 14% used a national guideline in managing patients.


CONCLUSIONS
(1) GERD is well recognized, but its related terminology is variable throughout the world. (2) There was variable and incomplete recognition of extra-esophageal manifestations GERD. (3) Recognition of extra-esophageal diseases caused by GERD is variable. (4) Current GERD guidelines are infrequently used by primary care physicians.
Vakil
Nimish
N
Division of Gastroenterology, University of Wisconsin Medical School, Milwaukee, Wisc., USA. nvakil@wisc.edu
Malfertheiner
Peter
P
Salis
Graciela
G
Flook
Nigel
N
Hongo
Michio
M
D005260:Female; D005764:Gastroesophageal Reflux / Q000145:classification* / Q000628:therapy*; D019983:Guideline Adherence; D019538:Health Care Surveys; D006801:Humans; D007391:International Cooperation; D008297:Male; D010821:Physicians, Family / Q000706:statistics & numerical data; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians'; D011320:Primary Health Care / Q000592:standards* / Q000639:trends; D011795:Surveys and Questionnaires; D009626:Terminology as Topic; D017749:Total Quality Management