title: Symptoms in patients on long-term proton pump inhibitors: prevalence and predictors.
abstract: BACKGROUND
  Symptom control in primary care patients on long-term proton pump inhibitor (PPI) treatment is poorly understood.
  
  
  OBJECTIVE
  To explore associations between symptom control and demographics, lifestyle, PPI use, diagnosis and Helicobacter pylori status.
  
  
  METHODS
  A cross-sectional survey (n = 726) using note reviews, questionnaires and carbon-13 urea breath testing. Determinants of symptom control [Leeds Dyspepsia Questionnaire (LDQ), Carlsson and Dent Reflux Questionnaire (CDRQ), health-related quality-of-life measures (EuroQoL: EQ-5D and EQ-VAS)] were explored using stepwise linear regression.
  
  
  RESULTS
  Moderate or severe dyspepsia symptoms occurred in 61% of subjects (LDQ) and reflux symptoms in 59% (CDRQ). Age, gender, smoking and body mass index had little or no influence upon symptom control or PPI use. Average symptom scores and PPI use were lower in patients with non-ulcer dyspepsia and gastro-protection than gastro-oesophageal reflux disease (GERD) and uninvestigated dyspepsia. H. pylori infection was associated with lower reflux symptom scores only in patients with GERD and uninvestigated dyspepsia. EQ-5D was not able to discriminate between diagnostic groups, although the EQ-VAS performed well.
  
  
  CONCLUSIONS
  A majority of patients suffered ongoing moderate or severe symptoms. GERD and uninvestigated dyspepsia were associated with poorer long-term symptom control; H. pylori appeared to have a protective effect on reflux symptoms in these patients.
authors.affiliation: School of Medicine and Health, Durham University, Wolfson Research Institute, University Boulevard, Stockton-on-Tees, UK. raghu@nath.freeserve.co.uk
authors.forename: A S
authors.initials: AS
authors.lastname: Raghunath
authors.forename: A P S
authors.initials: AP
authors.lastname: Hungin
authors.forename: J
authors.initials: J
authors.lastname: Mason
authors.forename: W
authors.initials: W
authors.lastname: Jackson
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001944:Breath Tests; D003430:Cross-Sectional Studies; D004305:Dose-Response Relationship, Drug; D004415:Dyspepsia / Q000188:drug therapy* / Q000453:epidemiology; D004739:England / Q000453:epidemiology; D005260:Female; D005764:Gastroesophageal Reflux / Q000150:complications / Q000188:drug therapy* / Q000453:epidemiology; D016481:Helicobacter Infections / Q000150:complications / Q000188:drug therapy* / Q000453:epidemiology; D016480:Helicobacter pylori; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D054328:Proton Pump Inhibitors / Q000009:adverse effects*; D011788:Quality of Life / Q000523:psychology; D011795:Surveys and Questionnaires
chemical_list: D054328:Proton Pump Inhibitors