Different characteristics of patients with gastro-oesophageal reflux disease on their path through healthcare: a population follow-up study

BACKGROUND: Only a minority of patients with gastro-oesophageal reflux symptoms (GORS) seek medical advice. Little is known about patient characteristics associated with consultation in primary care and referral to secondary care. AIMS AND METHODS: We compared the characteristics of patients with GORS in the general population, those who consulted their general practitioner (GP) and those referred to secondary care for upper endoscopy. We aimed to identify differences between patients with short term (<90 days) and chronic symptoms, and differences between patients with symptoms in primary and secondary care. The study was performed in a primary care based prospective dynamic population. RESULTS: In total, 16% of 7237 adult patients were identified with GORS. Twenty-five percent of these patients consulted the GP, of whom 40% were referred for endoscopy. Patients with chronic GORS were older, had a higher body mass index, were more often referred for upper endoscopy (all P<0.001) and more frequently had relevant findings during endoscopy (oesophagitis: 50% and Barrett's oesophagus: 10%). Patients referred for upper endoscopy were older than nonreferred patients (P<0.001). CONCLUSION: Only a minority of people with GORS visit their GP. After consulting referral for endoscopy occurs relatively often. Underlying endoscopic abnormalities are frequently found in patients with chronic GORS.