title: Discrepancies between upper GI symptoms described by those who have them and their identification by conventional medical terminology: a survey of sufferers in four countries.
abstract: OBJECTIVE
  The objective of this study was to develop a self-administered questionnaire for upper gastrointestinal (GI) symptoms using lay vocabulary uninfluenced by established medical terminology or concepts and to conduct a survey of symptom occurrence among sufferers in four countries.
  
  
  METHODS
  The questionnaire was designed by integrating information gained from the vocabulary used by 38 upper GI symptom sufferers. There was no medical input to its development. The questionnaire was then used, after appropriate translation, in Brazil, Russia, the UK and the USA. Details of 10 659 symptom episodes were obtained from 2665 individuals.
  
  
  RESULTS
  Nine symptoms described in lay vocabulary were identified during questionnaire development. Of these, one corresponded to regurgitation, whereas two that were distinguished by survey participants might both be interpreted as heartburn. One chest symptom for which a corresponding medical term was uncertain occurred in ∼30% of the respondents. Five different 'stomach' or abdominal symptoms were identified. The predominant symptom and the pattern of concurrent symptoms often varied from one symptom episode to another. Use of the terms 'heartburn', 'reflux', 'indigestion' and 'burning stomach' to describe symptoms varied between countries.
  
  
  CONCLUSIONS
  Some common upper GI symptoms described by those who suffer them have no clear counterpart in conventional medical terminology. Inadequacy of the conventional terminology in this respect deserves attention, first, to characterize it fully, and thereafter to construct enquiry that delivers more precise symptom identification. Our results suggest that improvement may require the use of vocabulary of individuals suffering the symptoms without imposing conformity with established symptom concepts.
authors.affiliation: aSchool of Medicine, Pharmacy and Health, Durham University, Durham bCategory Development Organisation, Reckitt Benckiser Plc, Slough, UK cChief Research Officer, Winkle BV, Keizersgracht , Amsterdam, The Netherlands dDepartment of Gastroenterology, Case Western Reserve University, Cleveland, Ohio, USA.
authors.forename: Robert C
authors.initials: RC
authors.lastname: Heading
authors.forename: Edward C M
authors.initials: EC
authors.lastname: Thomas
authors.forename: Phil
authors.initials: P
authors.lastname: Sandy
authors.forename: Gary
authors.initials: G
authors.lastname: Smith
authors.forename: Ronnie
authors.initials: R
authors.lastname: Fass
authors.forename: Pali S
authors.initials: PS
authors.lastname: Hungin
mesh_terms: D000293:Adolescent; D000328:Adult; D001938:Brazil; D032921:Consensus; D004415:Dyspepsia / Q000145:classification / Q000175:diagnosis / Q000453:epidemiology*; D005260:Female; D005764:Gastroesophageal Reflux / Q000145:classification* / Q000175:diagnosis / Q000453:epidemiology; D005767:Gastrointestinal Diseases / Q000145:classification* / Q000175:diagnosis / Q000453:epidemiology; D006306:Health Surveys; D006356:Heartburn / Q000145:classification* / Q000175:diagnosis / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D012426:Russia; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D009626:Terminology as Topic; D006113:United Kingdom; D014481:United States; D014825:Vocabulary; D055815:Young Adult