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

Abstract

SUMMARY BackgroundUpper gastrointestinal symptoms impose a substantial illness burden and management costs. Understanding perceptions and reasons for seeking healthcare is a prerequisite for meeting patients' needs effectively.

Depression and treatment with antidepressants are associated with the development of gastro‐oesophageal reflux disease

“…21,22 It should, however, be noted that anxiety is also known to be associated with increased consultation for GERD and dyspepsia. 7,23 Thus, patients with anxiety and stress disorders, as well as patients with depression, may simply be more likely to consult their PCP about their symptoms and therefore be more likely to receive a GERD diagnosis than patients without psychiatric disorders. However, the risk estimates in the present study were adjusted for consultation rate and therefore it is unlikely that this association is solely dependent on consultation behaviour.…”

Selective-serotonin reuptake inhibitors for the treatment of hypersensitive esophagus

“…Gastroesophageal reflux disease (GERD) which is evident from symptoms or mucosal damage caused by the reflux of gastric contents into the esophagus is one of the most common chronic gastrointestinal diseases in Western countries [Hungin et al 2009;Lagergren et al 1999;Kahrilas, 1996]. The role of acid is well established in the pathogenesis of GERD and medical treatment of this condition is primarily based on gastric acid suppression by agents such as proton-pump inhibitors (PPIs) [Malfertheiner et al 2006].…”

Non-pharmacological intervention for gastro-oesophageal reflux disease in primary care

“…25 If this is the case, maintaining patients on, or weaning them off PPIs without giving them a means of managing their symptoms will be very difficult. If, as suggested, the way forward with reflux management is to use more than one approach, 9,26 an education intervention alongside a carefully managed PPI programme 27 may have the potential to reduce the long-term use of PPIs and avoid the problem of rebound acid production as well as improving quality of life.…”

“…7 Experimental studies have attempted to determine factors that exacerbate GORD symptoms, while population studies have explored socioeconomic and emotional issues that may influence symptom experience. 8 Current advice is that more than one approach may be needed to treat GORD, 9 but the potential for lifestyle management as an effective companion or alternative to PPIs has been under-researched. Guidelines that do mention lifestyle management offer limited guidance and tend to focus on medical and surgical techniques to control GORD No previous UK study has used behavioural change interventions to help patients self-manage their symptoms.…”