Gastroesophageal reflux disease (GERD) is frequently managed by primary-care physicians although little is known about their current practices and management patterns.
Dr Chey and colleagues from Chicago administered a questionnaire-based survey to primary-care physicians attending sponsored educational conferences on GERD.
Questionnaires were completed anonymously before the conferences and asked about prescribing patterns, indications for surgical referral.
|80% of primary-care physicians tested for H pylori in patients who only had GERD symptoms|
|American Journal of Gastroenterology|
The researchers also asked questions about issues concerning Barrett's esophagus and Helicobacter pylori infection.
The research team received a total of 1046 completed questionnaires, a 97 % acceptance rate.
The researchers found that most primary-care physicians prescribed a proton pump inhibitor (PPI) for GERD without prior authorization and without first using an H2-receptor antagonist.
The team noted that many gave an H2-receptor antagonist with once-daily PPI treatment for patients with nocturnal heartburn.
Most referrals for anti-reflux surgery were for inadequate response to medical treatment.
However, the team found that primary-care physicians usually first sought gastroenterological consultation.
The researchers noted a widespread acceptance of screening GERD patients for Barrett's esophagus.
In addition, the researchers observed general confusion about any relationship between H pylori infection and GERD.
The team reported that 80% of primary-care physicians tested for H pylori infection in at least some patients who only had symptoms of GERD.
Dr Chey's team concluded, “Our survey has identified a number of areas of controversy and confusion related to the management of GERD.”
“We hope that our findings can assist in the development of educational materials on GERD for primary-care physicians.”