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Questionnaires helped identify 'symptomatically silent' GERD patients
Structured patient-completed questionnaires, combined with standard physician interviews, increased the proportion of accurately diagnosed patients with GERD who were asymptomatic for heartburn or regurgitation, according to recent research data.
To estimate the prevalence of untreated “symptomatically silent” GERD, researchers evaluated 336 patients from northwestern Europe and Canada aged 18 to 79 years who had frequent upper GI symptoms and had not taken a proton pump inhibitor 2 months before the study. Physicians evaluated patients’ symptoms, and patients completed self-reports using the Reflux Disease Questionnaire (RDQ). Patients also underwent upper gastrointestinal endoscopy within 10 days of RDQ and 48-hour esophageal pH-metry.
GERD was diagnosed in 58.6% of patients, with 84.3% reporting heartburn and/or regurgitation in physician interview, compared with 93.4% in the RDQ. Of 31 patients with these symptoms who were not diagnosed by a physician, 18 reported the frequency and severity of symptoms as “troubling” on the RDQ, and nine GERD patients did not report either symptom in physician interview or RDQ. Overall, 95.4% GERD patients were screened successfully for heartburn and/or regurgitation by physician and/or RDQ.
“Structured patient-completed questionnaires can be useful adjuncts to physician interviews in primary care and may identify more patients with GERD than physician interviews alone,” the researchers concluded. “However, a small proportion of patients with GERD diagnosed by endoscopy, pH-metry, and/or positive [symptom association probability] on investigation do not report any heartburn or regurgitation either at physician interview or on a self-completed questionnaire.”
Disclosure: See the study for a full list of relevant financial disclosures.