Medical Consultation for Gastro-Oesophageal Reflux Symptoms: Reasons and Associated Factors

Abstract

Objectives: To evaluate the frequency of medical consultation for gastro-oesophageal reflux symptoms (GORS) and to ascertain reasons for consultation and associated factors. Methods: Telephone survey of 2,500 persons using a validated questionnaire. Data were analyzed using multiple logistic regression, in which the dependent variable was consultation for GORS and the independent variables were sociodemographic factors and the clinical characteristics of GORS. Results: Of those reporting GORS, 28% had consulted their physician about them in the last year. Main reasons for seeking medical advice were GORS-induced concern in 48%, and intensity of GORS in 42.6%. Factors independently associated with medical consultation were: housewife (odds ratio (OR) 1.9; 95% CI 1.1–3.4) or retired status (OR 2.3; 95% CI 1.3–4.1), frequent GORS (OR 2.4; 95% CI 1.6–3.5), severe GORS (OR 2.4; 95% CI 1.4–4.2), nocturnal GORS (OR 1.6; 95% CI 1.1–2.3), and association of epigastric pain (OR 1.7; 95% CI 1.0–2.7) or nausea (OR 1.7; 95% CI 1.1–2.8). Conclusion: The high frequency of medical consultation for GORS in Spain makes it an important healthcare problem. The fact that half the patients seek medical advice due to concern about the nature of GORS illustrates the benefits of explaining the nature, treatment and prognosis of GORS. The clinical relevance of GORS does not reside in its frequency alone, since severe or nocturnal symptoms, albeit occasional, are also associated with medical consultation.

Systematic review: frequency and reasons for consultation for gastro‐oesophageal reflux disease and dyspepsia

“…Rey et al found that 42.6% of the individuals in their study sample who consulted a physician about GERD did so because of the severity of their symptoms. 22 In this study, both frequent symptoms (OR: 2.4; 95% CI: 1.6-3.5) and severe symptoms (OR: 2.4; 95% CI: 1.4-4.2) were independently associated with consultation. Total number of unique hits: n = 1166…”

“…19 Several other studies also reported consultation rates of about 30% per year. [20][21][22][23] A substantially higher consultation rate was found in a survey of 2000 individuals in Belgium. 24 Almost 30% of this survey population reported having symptoms of heartburn in the previous year, 56% of whom had consulted a physician about these symptoms.…”

“…In a qualitative, international survey of 164 individuals with GERD, one of the key factors that influenced consultation behaviour was whether the symptoms interfered with social activities. 8 A second survey also found that individuals who felt that their heartburn seriously hampered their daily lives were significantly more likely to consult 29 (n = 3151) Ho et al 21 (n = 696) Jafri et al 23 (n = 1267) Rey et al 22 (n = 2500) Johnston et al 30 (n = 217) Locke et al 25 (n = 1511) Nandurkar et al 31 (n = 242) Female gender Wong et al 27 (n = 2209) Kennedy and Jones 29 (n = 3151) Bretagne et al 19 (n = 5595) Ho et al 21 (n = 696) Rey et al 22 (n = 2500) Locke et al 25 (n = 1511) Johnston et al 30 (n = 217) Nandurkar et al 31 (n = 242) Socioeconomic status -Kennedy and Jones 29 (n = 3151) Ho et al 21 (n = 696) Higher education level Nandurkar et al 31 (n = 242) Rey et al 22 (n = 2500) Wong et al 27 (n = 2209) Professionally inactive Rey et al 22 (n = 2500) -Increased symptom frequency Rey et al 22 (n = 2500) Ho et al 21 (n = 696) Bretagne et al 19 (n = 5595) Locke et al 25 (n = 1511) Wong et al 27 (n = 2209) Nandurkar et al 31 (n = 242) Increased symptom severity Rey et al 22 (n = 2500) Nandurkar et al 31 (n = 242) Bretagne et al 19 (n = 5595) Ho et al 21 (n = 696) Wong et al 27 (n = 2209) Johnston et al 30 (n = 217) Presence of other symptoms Kennedy and Jones 29 (n = 3151) -Frank et al 61 (n = 2056) Impact of GERD on quality of life ⁄ daily living Bretagne et al …”

“…19 Further four studies found no evidence of an association between age and consultation behaviour. 21,22,25,27 A study in Spain found that individuals who were not subject to a work timetable were more likely to consult a physician about their reflux symptoms. 22 This study found that retired individuals (OR: 2.3; 95% CI: 1.3-4.1) and housewives (OR: 1.9; 95% CI: 1.1-3.4) were more likely to seek a consultation than other occupational groups.…”

“…21,22,25,27 A study in Spain found that individuals who were not subject to a work timetable were more likely to consult a physician about their reflux symptoms. 22 This study found that retired individuals (OR: 2.3; 95% CI: 1.3-4.1) and housewives (OR: 1.9; 95% CI: 1.1-3.4) were more likely to seek a consultation than other occupational groups. However, a second, international study found a belief that symptoms interfered with work to be a key factor influencing individuals with GERD to seek healthcare.…”