Digestive complaints, clinical decisions and endoscopy in primary care

The objectives of the present survey is the knowledge of relative frequency of digestive complaints in population presenting to the general practitioner and of the decisions undertaken by the physician. We have enrolled 51 practitioners in the suburban area of Rome; they have completed a form for every patient with digestive complaints during three months. The patients were referred, if necessary, to two outpatient clinics of Gastroenterology and Digestive Endoscopy. Results are: out of 24.250 patients 1.086 (4.5%) presented for digestive complaints with a total of 3.062 complaints (2.8% patient). Upper tract has been responsible for 41.8% of total complaints (main complaint hearburn: 9%), lower tract for 31.5% (main complaint abdominal distension: 13.2%); non specific complaints accounted for 26.6% (main complaint pain: 20.3%). General practitioners have prescribed drugs most commonly (36.1%); following decisions in order of frequency were: clinical investigations (22.6%), manipulations of diet (20.9%), to observe (12.6%), gastroenterologist consultation (6%). Radiological investigations were preferred to endoscopy (38.9% of total investigations vs. 28.3%); laboratory tests represented 18.3% of investigations and echography 13.4%. Endoscopy diagnosed 21 peptic ulcers (six gastric) and six tumors (three colon benign polyps).