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Health status and management of chronic non-specific abdominal complaints in general practice
H A Janssen1, J A Borghouts, J W Muris
1Department of General Practice, Maastricht University, The Netherlands.
Background:
While chronic non-specific abdominal complaints are common in general practice, data on patients' perspective and management of these complaints are lacking. Knowledge of these data is important for the development of guidelines for management and assessment of the burden of chronic non-specific abdominal complaints on society.
Aim:
To draw a comprehensive picture of chronic non-specific abdominal complaints in general practice, including volume, patients' perspective, and health care involvement.
Method:
In a retrospective study, 644 patients were selected in 16 general practices. Patients and general practitioners (GPs) received a questionnaire regarding the nature of complaints and health care management during the previous 12 months.
Results:
Overall, 619 questionnaires were returned and 291 patients participated. Of the study population, 15% of patients were diagnosed as suffering from non-ulcer dyspepsia, 39% from irritable bowel syndrome, and 45% from other abdominal complaints. Over 50% of patients suffered from chronic non-specific abdominal complaints on a daily or weekly basis. In these patients, general health perception is impaired and above norm scores on SCL-anxiety and SCL-depression scales were recorded. Only 4% of patients showed complete resolution of complaints during the previous 12 months. Fifty-two per cent of patients consulted their GP for abdominal complaints. Diagnostic modalities were used frequently. Medication was prescribed in 83% of patients with abdominal complaints. Twenty per cent of patients were referred to secondary or tertiary care. There was a considerable inter-doctor variation in the management of chronic non-specific abdominal complaints.
Conclusion:
Once non-specific abdominal complaints have become chronic they are mainly managed by the GP. The impact on patients' physiological and psychological well being is large. Diagnostic and therapeutic modalities are frequently used. Given the considerable inter-doctor variation, research into the evidence base of management strategies is recommended.
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