[Selection of patients referred to gastroscopy from general practice]

The aim of this study was to investigate whether guidelines for selecting dyspeptic patients for early endoscopy are appropriate and whether referrals from general practitioners give all necessary information.

We carried out a prospective study of consecutive referrals from general practitioners. The patients were referred by general practitioners to the Department of Medical Gastroenterology, Aalborg Hospital, during the period 1 February 1999 to 31 December 1999. The referrals for endoscopy were examined for information about the duration of symptoms, alarm symptoms (anaemia, dysphagia, vomiting, and weight loss), usage of ASA/NSAID, and medical treatment with acid-suppressants. At endoscopy, similar information was recorded on a standardised form for comparison.

Two hundred and ninety-nine patients, 150 men and 149 women, were entered in the study. The medium age was 51.3 years (17-95). Ninety-six (32%) patients had organic dyspepsia (ulcer, oesophagitis, cancer). Of 192 (46%) patients selected for early gastroscopy, 88 (46%) were assigned to early examination solely because of age > 45 years, and 21 (11%) solely because of alarm symptoms. All the patients with information about ASA/NSAID medication were older than 45 years. The diagnosis of cancer and ulcer was significantly more often found in the group of patients selected for early gastroscopy 31/192, as compared with the waiting list patients 9/107 (p = 0.004).

The guidelines for distribution to early and waiting list endoscopy proved to be well suited for priority selection of patients with the highest risk of organic dyspepsia.