General practitioners approach to dyspepsia - Survey of consultation frequencies, treatment, and investigations

Background: The aim of this study was to investigate the frequency of patient visits for dyspepsia in primary care. The diagnostic approaches made and drug treatment given by general practitioners were recorded. Methods: In a cross-sectional study 36,230 patients over 15 years of age visited their health center in an area serving a population of 506,000 inhabitants, between 6 and 19 May 1991. The frequency of dyspepsia was 2.1% (n = 766). These patients formed the basis of this study. Results: The incidence of dyspepsia leading to a health center visit was 20.9/1000 inhabitants/year. Patients older than 45 years consulted their general practitioners for dyspepsia more often than younger patients. Men older than 45 years of age had had their symptoms longer before seeking medical advice than younger men or women of the same age (p = 0.03 and p < 0.05, respectively). In association with the first visit, older (over 45 years) patients were evaluated more frequently (p = 0.03) by upper gastrointestinal endoscopy than younger (15-44 years) ones. Upper abdominal ultrasound was performed almost as often as upper gastrointestinal endoscopy. Sucralfate was prescribed for dyspeptic symptoms more often than H-2-blockers or omeprazole, which were mainly used in patients with a definitive diagnosis. Conclusions: The frequency of medical visits for dyspepsia increased with age. Older men sought medical advice for dyspepsia after a longer delay than others. Upper abdominal endoscopy was performed in association with the. first visit in older patients more often than in younger ones.