The health economic impact of upper gastrointestinal symptoms in the general population: Results from the Domestic/International Gastroenterology Surveillance Study (DIGEST)

Background: The Domestic/International Gastroenterology Surveillance Study (DIGEST) is the first large, multinational, population-based survey to assess the 3-month prevalence and economic/quality-of-life impact of upper gastrointestinal symptoms (UGIS). Methods: A total of 5581 subjects were interviewed in 10 countries (grouped into seven regions). Respondents were classified as having relevant or non-relevant upper gastrointestinal symptoms, and questioned about consumption of healthcare resources in terms of doctor consultations, prescribed and non-prescribed medications, hospital stays and investigations for both gastrointestinal and other health problems. The impact of symptoms in terms of time lost and reduced effectiveness at work or social activities was also recorded. Results and conclusions: Twenty-eight percent of the total sample was defined as having clinically relevant UGIS (UGIS of at least moderate severity and with a frequency of at least once per week in the previous 3 months). During the period studied, 20% of these subjects had consulted a family practitioner (16.2%) and/or a specialist (6.3%), primarily for UGIS. Of those with clinically relevant UGIS, 49% had taken over-the-counter medication, and 27% prescription medication for gastrointestinal (GI) symptoms. Two percent reported a hospital stay and 27% reported days of reduced or no work, school or domestic productivity due to UGIS. Four percent of all study subjects underwent investigations for UGIS during this period. Variations between countries in these parameters may be due to differences in healthcare systems and cultural attitudes towards UGIS, influencing both the healthcare-seeking behaviour of subjects with UGIS and their management.