title: Upper gastrointestinal symptoms in medical professionals: a higher burden?
abstract: OBJECTIVE
  Gastroesophageal reflux disease (GERD) and dyspepsia cause significant healthcare resource utilization and greatly affect quality of life; therefore, a tendency exists to self-treat in lieu of formal diagnosis. Although their prevalence is established in the general population, their prevalence in physicians remains unknown. Our aim was to estimate the prevalence of GERD and dyspepsia symptoms in a sample of medical professionals by level of training.
  
  
  METHODS
  An anonymous, computer-based questionnaire was distributed to medical students, residents/fellows, and attending physicians at our institution. The survey included symptom-based questions for GERD (Reflux Disease Questionnaire); quality-of-life questionnaire for dyspepsia (Nepean Dyspepsia Index [NDI]), and the Gastroparesis Cardinal Symptom Index (GCSI). We calculated scores based on the validated system from each questionnaire and used appropriate statistical analysis to evaluate associations between symptomatology and training level (medical students, residents/fellows, and attending physicians).
  
  
  RESULTS
  Overall, there were 327 respondents (155 medical students, 127 residents/fellows, 45 attending physicians), of whom 52% were women, 56% were white non-Hispanic, 19% were Hispanic, and 74% were born in the United States/Canada. A total of 21% reported previously diagnosed GERD/dyspepsia, and 42% reported previously or currently using a medication for GERD/dyspepsia, with significantly higher use of proton pump inhibitors in attending physicians than in medical students and residents/fellows (P < 0.01). Higher median total scores for the NDI (P = 0.01) and GCSI (P < 0.01) in medical students exist compared with residents/fellows and attending physicians, with no significant differences for the Reflux Disease Questionnaire among groups.
  
  
  CONCLUSIONS
  Although the prevalence of diagnosed GERD/dyspepsia in our sample was comparable to the general population, medication use was higher. Self-treatment with prescription medications increased with training. Median NDI and GCSI scores were inversely related to training level, which may reflect self-treatment in medical professionals with advanced training. Further study of GERD/dyspepsia in medical professionals is warranted.
authors.affiliation: From the Department of Medicine, Division of Gastroenterology, Leonard M. Miller School of Medicine, University of Miami, Miami, Florida.
authors.forename: Jodie A
authors.initials: JA
authors.lastname: Barkin
authors.affiliation: From the Department of Medicine, Division of Gastroenterology, Leonard M. Miller School of Medicine, University of Miami, Miami, Florida.
authors.forename: Morgan A
authors.initials: MA
authors.lastname: Sendzischew
authors.affiliation: From the Department of Medicine, Division of Gastroenterology, Leonard M. Miller School of Medicine, University of Miami, Miami, Florida.
authors.forename: David C
authors.initials: DC
authors.lastname: Landy
authors.affiliation: From the Department of Medicine, Division of Gastroenterology, Leonard M. Miller School of Medicine, University of Miami, Miami, Florida.
authors.forename: Baharak
authors.initials: B
authors.lastname: Moshiree
mesh_terms: D000328:Adult; D004415:Dyspepsia / Q000188:drug therapy / Q000453:epidemiology*; D005260:Female; D005764:Gastroesophageal Reflux / Q000188:drug therapy / Q000453:epidemiology*; D006282:Health Personnel / Q000706:statistics & numerical data*; D006801:Humans; D007396:Internship and Residency / Q000706:statistics & numerical data; D008297:Male; D008505:Medical Staff, Hospital / Q000706:statistics & numerical data; D008875:Middle Aged; D015995:Prevalence; D054328:Proton Pump Inhibitors / Q000627:therapeutic use; D013337:Students, Medical / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology; D055815:Young Adult
chemical_list: D054328:Proton Pump Inhibitors