Self-management and help-seeking behavior for gastroesophageal reflux symptoms: A population-based survey

Despite societal guidelines recommending targeted screening for Barrett's esophagus (BE) and esophageal adenocarcinoma (EAC) in individuals with gastroesophageal reflux symptoms (GERS), screening adherence is suboptimal. Current screening approaches fail to identify individuals not seeking medical consultation for GERS or whose GERS are managed with 'over-the-counter' (OTC) acid suppressant therapies.

To assess patients' self-management and help-seeking behavior for GERS.

This cross-sectional study collected data from the Dutch general population aged 18-75 years between January and April 2023 using a web-based survey. The survey included questions regarding self-management (e.g., use of acid suppressant therapy with or without prescription) and help-seeking behavior (e.g., consulting a primary care provider) for GERS. Simple random sampling was performed to select individuals within the target age group. In total, 18156 randomly selected individuals were invited to participate. The study protocol was registered in ClinicalTrials.gov (identifier: NCT05689918).

Of the 18156 invited individuals, 3214 participants (17.7%) completed the survey, of which 1572 participants (48.9%) reported GERS. Of these, 904 participants (57.5%) had never consulted a primary care provider for these symptoms, of which 331 participants (36.6%) reported taking OTC acid suppressant therapy in the past six months and 100 participants (11.1%) fulfilled the screening criteria for BE and EAC according to the European Society of Gastrointestinal Endoscopy Guideline.

The population fulfilling the screening criteria for BE and EAC is incompletely identified, suggesting potential underutilization of medical consultation. Raising public awareness of GERS as a risk factor for EAC is needed.