Dyspeptic symptoms in primary care. An observational study in general practice

Area of Science:

• Gastroenterology
• General Practice
• Epidemiology

Background:

• Dyspepsia is a common condition leading patients to consult general practitioners.
• Investigation of dyspepsia often occurs in specialized referral centers.
• This study examines dyspepsia in primary care in Italy.

Purpose of the Study:

• To describe the features of dyspepsia in patients seen by Italian general practitioners.
• To investigate the relationship between dyspepsia symptoms and demographic, clinical, and socio-economic factors.
• To assess the workload associated with dyspepsia in primary care.

Main Methods:

• 10,000 Italian general practitioners recruited up to 10 consecutive dyspeptic patients.
• A validated questionnaire assessed symptom severity (0-3) including painful/non-painful dyspepsia, retrosternal pain/burning, and abdominal distension.
• Demographic, clinical, and socio-economic data were collected.

Main Results:

• 43,446 patients were included; 55% male, 50% over 45, 49% smokers.
• Dyspepsia constituted 8.3% of consultations for a subset of doctors.
• Epigastric pain (84%) and fullness (79%) were common; 69% had moderate-severe symptoms.
• Predominant pain (21%) was linked to male gender, smoking, reflux; predominant discomfort (25%) to female gender, distension.
• Age, education, and work status did not correlate with symptom patterns.

Conclusions:

• Dyspepsia represents a significant workload for general practitioners.
• There is considerable overlap among digestive symptoms, complicating diagnosis.
• A smaller proportion of patients may be eligible for empirical treatment than anticipated by guidelines.