Dyspepsia consulters and patterns of management: a population-based study

Area of Science:

• Gastroenterology
• Health Services Research
• Epidemiology

Background:

• Dyspepsia is a prevalent gastrointestinal disorder with poorly understood management patterns in the United States.
• Understanding long-term care delivery is crucial for improving patient outcomes and healthcare resource allocation.

Purpose of the Study:

• To analyze the 20-year management trends for dyspepsia in a population-based cohort.
• To investigate whether dyspepsia subgroup and gender influence evaluation and treatment strategies.

Main Methods:

• A population-based cohort in Olmsted County, Minnesota, was studied using validated questionnaires and medical record review.
• 213 individuals meeting Rome I Criteria for dyspepsia were identified, with medical charts reviewed for 10 years pre- and post-survey.
• Dyspepsia subgroups included ulcer-like, dysmotility-like, and reflux-like types.

Main Results:

• Nearly half of subjects received care for dyspepsia over 20 years, with upper endoscopy being the most common diagnostic test (49%).
• Primary care physicians managed most initial visits (72%), with 'acid' and 'functional' diagnoses being most frequent.
• Acid suppression agents were widely prescribed (78%), but women were less likely to receive proton pump inhibitors.

Conclusions:

• Dyspepsia care delivery demonstrated consistency across different dyspepsia subgroups and between genders.
• Symptom characteristics, including severity and frequency, were identified as key drivers for seeking healthcare.
• Further research may explore gender-specific treatment disparities, particularly regarding proton pump inhibitor use.