Measuring the frequency of functional gastrointestinal disorders in rural Crete : a need for improving primary care physicians' diagnostic skills

• Introduction: Studies of the frequency and aetiology of functional gastrointestinal disorders in the general population have received increasing interest over the past few years; the field seems to be neglected in Southern Europe. The aim of this study was to report on the frequency of functional dyspepsia (FD), irritable bowel syndrome (IBS) and gastroenteritis within the primary care setting, to provide some information on the extent to which the recorded diagnoses in the physicians’ notes fulfil existing diagnostic criteria. Method: A retrospective study was used, where all new cases of these diseases at five primary health care centres in three rural and two semi-rural areas of Crete were identified by scrutinising medical records from 280 000 consecutive visits during a 4 year period. The occurrence rate per 1000 person-years were calculated for the three conditions. We also checked the extent to which the Talley’s criteria for FD and Rome II diagnostic criteria for IBS were followed. Results: Gastroenteritis was revealed to be a quite frequent health problem among the rural population on Crete, while the occurrence rates for other problems, such as dyspepsia and IBS, were found to be lower than expected. IBS was over-represented among women compared with men, OR 2.04 (CI 1.39-3.00). In many cases a diagnosis of FD, IBS or gastroenteritis was evident to the research team on the basis of findings recorded in the notes, but the diagnosis was not recorded by the clinician at the time of consultation. Conclusions: This study yielded two key messages: the first that gastroenteritis is still a frequent health problem, and the second that primary care physicians in rural Crete seem to fail in adequately diagnosing FD and IBS and need further training.

Nyckelord

Adolescent

Adult

Age Distribution

Aged

Aged; 80 and over

Clinical Competence/statistics & numerical data

Dyspepsia/diagnosis/epidemiology

Female

Gastroenteritis/diagnosis/epidemiology

Gastrointestinal Diseases/*diagnosis/*epidemiology

Greece/epidemiology

Humans

Incidence

Irritable Bowel Syndrome/diagnosis/epidemiology

Male

Middle Aged

Needs Assessment

Primary Health Care/*statistics & numerical data

Research Support; Non-U.S. Gov't

Retrospective Studies

Rural Health Services/*statistics & numerical data

Sex Distribution

MEDICINE

MEDICIN

Publikations- och innehållstyp

ref (ämneskategori)

art (ämneskategori)