THE SYMPTOMS OF UPPER GASTROINTESTINAL, PSYCHOSOCIAL CO-MORBIDITY, EFFECTS ON PATIENTS & HEALTH CARE SEEKING IN GENERAL PRACTICE

There is also a limited understanding of the pathophysiology of upper gastrointestinal (GI) effects. In patients with functional gastrointestinal problems, psychological symptoms have been shown to be more frequent, although it is disputed if they are directly related to GI symptoms or rather indicate reasons for seeking health treatment. The aim of our research was to compare co-morbidity between patients with and without upper GI symptoms, particularly psychological and social problems. Furthermore, we explored whether the occurrence of psychiatric and social disorders was part of a larger trend of health care utilization due to sickness. Case control research focused on the population based on the second Dutch National Survey of General Practice (conducted in 2001). Cases and controls (individuals not experiencing any of these complaints) matched by gender, age, PCP-practice and ethnicity were contrasted (adults attending their primary care provider (PCP) with upper GI symptoms). The key outcome indicators were communication duration, somatic and psychosocial diagnosis prevalence, (psycho) pharmacological agent dosage levels, and referral rates. Using odds ratios, the Chi square test and multivariable logistic regression analysis, the data was analyzed. As a result, data was analyzed for 13,389 patients with upper GI signs and 13,389 control patients. Twice as often as controls (8.6 vs 4.4 times/year), patients with upper GI symptoms attended their PCP. There were not only more psychiatric and emotional issues in people with upper GI signs, but also more clinical problems in their PCP (odds ratios (ORs) ranged from 1.37 to 3.45). Drugs of any ATC type (ORs range from 1.39 to 2.90), including psychotropic agents, have been used most commonly in patients with upper GI symptoms. When we corrected for non-attending control patients, the found variations were less pronounced. In the multivariate regression study, patients with upper GI effects were more closely correlated with communication frequency and not psychiatric or social co-morbidity. To conclude, people with upper GI symptoms most often attend their PCP for some organ system issues, even psychosocial problems. The correlation between upper GI symptoms and psychological issues is misleading and could represent higher health care standards in general. Keywords: gastrointestinal