title: Different characteristics of patients with gastro-oesophageal reflux disease on their path through healthcare: a population follow-up study.
abstract: BACKGROUND
  Only a minority of patients with gastro-oesophageal reflux symptoms (GORS) seek medical advice. Little is known about patient characteristics associated with consultation in primary care and referral to secondary care.
  
  
  OBJECTIVE
  We compared the characteristics of patients with GORS in the general population, those who consulted their general practitioner (GP) and those referred to secondary care for upper endoscopy. We aimed to identify differences between patients with short term (<90 days) and chronic symptoms, and differences between patients with symptoms in primary and secondary care. The study was performed in a primary care based prospective dynamic population.
  
  
  RESULTS
  In total, 16% of 7237 adult patients were identified with GORS. Twenty-five percent of these patients consulted the GP, of whom 40% were referred for endoscopy. Patients with chronic GORS were older, had a higher body mass index, were more often referred for upper endoscopy (all P<0.001) and more frequently had relevant findings during endoscopy (oesophagitis: 50% and Barrett's oesophagus: 10%). Patients referred for upper endoscopy were older than nonreferred patients (P<0.001).
  
  
  CONCLUSIONS
  Only a minority of people with GORS visit their GP. After consulting referral for endoscopy occurs relatively often. Underlying endoscopic abnormalities are frequently found in patients with chronic GORS.
authors.affiliation: Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: Roos D
authors.initials: RD
authors.lastname: Flameling
authors.forename: Mattijs E
authors.initials: ME
authors.lastname: Numans
authors.forename: Jose
authors.initials: J
authors.lastname: ter Linde
authors.forename: Niek J
authors.initials: NJ
authors.lastname: de Wit
authors.forename: Peter D
authors.initials: PD
authors.lastname: Siersema
mesh_terms: D000208:Acute Disease; D000328:Adult; D017677:Age Distribution; D001471:Barrett Esophagus / Q000453:epidemiology / Q000473:pathology / Q000628:therapy; D015992:Body Mass Index; D002908:Chronic Disease; D016099:Endoscopy, Gastrointestinal / Q000706:statistics & numerical data; D004941:Esophagitis / Q000453:epidemiology / Q000473:pathology / Q000628:therapy; D005194:Family Practice / Q000706:statistics & numerical data; D005260:Female; D005500:Follow-Up Studies; D005764:Gastroesophageal Reflux / Q000453:epidemiology* / Q000473:pathology / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D015995:Prevalence; D011320:Primary Health Care / Q000706:statistics & numerical data; D012017:Referral and Consultation / Q000706:statistics & numerical data*