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Acid-related disorders?including gastroesophageal reflux disease (GERD), peptic ulcer disease (PUD), and dyspepsia?are common in the United States. In the November 2003 issue of the American Journal of Gastroenterology, Sumit R. Majumdar, MD, MPH, and colleagues reported their findings from a population-based cohort study of 216,720 members of a managed care organization. The study focused on the prevalence of chronic acid-related disorders and rates of adherence to current guidelines for the investigation of PUD and dyspepsia.
The results demonstrated that 2.3% of this patient population had chronic acid-related disorders that required the use on a long-term basis ( 1 year) of prescription acid-suppressing medications, including histamine type 2 blockers and proton pump inhibitors (PPIs). Among patients with chronic acid-related disorders (n = 5064), 59% had GERD, 35% had presumptive dyspepsia (82% of whom were not investigated by endoscopy), and 6% had PUD (34% of whom had never been tested for Helicobacter pylori infection). The use of PPI monotherapy was highest among patients with GERD (31%) and lowest among patients with uninvestigated dyspepsia (12%).
Although chronic acid-related disorders and long-term use of acid-suppressing medications are common among primary care patients, the authors conclude that these patients are underinvestigated.