Management of reflux disease in clinical praxis in Hungary

Research output: Article

2 Citations (Scopus)

Abstract

Background: Gastro-oesophageal reflux disease (GERD) is a chronic condition that affects a large proportion of the population. The majority of patients are treated in the primary care but effective management of the disease still remains a challenge for specialists as well. A recent survey - based on the case of a typical GERD patient - conducted in Germany indicated that mainly specialists adhered to the guidelines. Aim: The purpose of this study was to conduct a survey among specialists and primary care physician members of the Hungarian Society of Gastroenterology about the practical management of GERD using the same questionnaire as in the German study. Methods: A questionnaire based on the case of a typical patient with GERD was sent out to a total of 1090 members of the society. The questions concerned general measures for avoiding reflux symptoms (dietary and life-style modifications), diagnosis of GERD and the type of treatment. Answers were compared with those in the German study. Results: A total of 421 questionnaires were evaluated (38%), which had been returned by 174 general practitioners (GP), 173 gastroenterologists (GE), 41 paediatricians, and 33 surgeons. Only 9% (38/421) of the responders think that there is no necessity to carry out specific diagnostic approaches before starting any treatment. In 91% of the cases (25% always and 66% only if symptoms persist) doctors carry out specific diagnostic tests (75% endoscopy, 13% 24 hours pH-metry, and 12% X-ray). 47% of responders start drug treatment at once while 35% start meications only after getting the results of the requested examinations. 18% of Hungarian doctors do start with a non-medical therapy. Almost all responders feel that it is important to advise a reduction of weight and a cessation of smoking for GERD patients. Altering specific dietary and life-style habits was considered useful by more than 85% of our responders. Hungarian physicians were more concerned about different alcoholic drinks and spicy, fatty or bloating meals and less about sweets than their German counterparts. More than 85% of GPs administer some kind of drug therapy as first choice. Over 65% of GPs are using the step-down approach with proton pump inhibitors as the initial strategy and 78%, 76%, and 81% of GEs, paediatricians, and surgeons, respectively, do the same. Almost one-third of GPs and paediatricians are willing to continue therapy and almost two-thirds of GPs will reduce the dose of current medical therapy if the GERD patient is responding well to the initial therapy. Conclusions: Irrespective of the country, specialists are adhering more strictly to the guidelines on the diagnosis and treatment of GERD than general practitioners. The majority of responders, however, ask for endoscopy prior to initiation of any medication and use the step-down approach. Despite the lack of scientific evidence, reduction of weight, cessation of smoking, dietary and life-style modifications are still part of the treatment of GERD in both Germany and Hungary.

Original languageEnglish
Pages (from-to)575-580
Number of pages6
JournalZeitschrift fur Gastroenterologie
Volume43
Issue number6
DOIs
Publication statusPublished - jún. 2005

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Esophageal Diseases
Hungary
Disease Management
Gastroesophageal Reflux
Life Style
Therapeutics
Smoking Cessation
General Practitioners
Endoscopy
Germany
Weight Loss
Guidelines
Proton Pump Inhibitors
Primary Care Physicians
Routine Diagnostic Tests
Habits
Meals
Primary Health Care
X-Rays
Surveys and Questionnaires

ASJC Scopus subject areas

  • Gastroenterology

Cite this

@article{beb983e4e6a746f8b198368ca24d1295,
title = "Management of reflux disease in clinical praxis in Hungary",
abstract = "Background: Gastro-oesophageal reflux disease (GERD) is a chronic condition that affects a large proportion of the population. The majority of patients are treated in the primary care but effective management of the disease still remains a challenge for specialists as well. A recent survey - based on the case of a typical GERD patient - conducted in Germany indicated that mainly specialists adhered to the guidelines. Aim: The purpose of this study was to conduct a survey among specialists and primary care physician members of the Hungarian Society of Gastroenterology about the practical management of GERD using the same questionnaire as in the German study. Methods: A questionnaire based on the case of a typical patient with GERD was sent out to a total of 1090 members of the society. The questions concerned general measures for avoiding reflux symptoms (dietary and life-style modifications), diagnosis of GERD and the type of treatment. Answers were compared with those in the German study. Results: A total of 421 questionnaires were evaluated (38{\%}), which had been returned by 174 general practitioners (GP), 173 gastroenterologists (GE), 41 paediatricians, and 33 surgeons. Only 9{\%} (38/421) of the responders think that there is no necessity to carry out specific diagnostic approaches before starting any treatment. In 91{\%} of the cases (25{\%} always and 66{\%} only if symptoms persist) doctors carry out specific diagnostic tests (75{\%} endoscopy, 13{\%} 24 hours pH-metry, and 12{\%} X-ray). 47{\%} of responders start drug treatment at once while 35{\%} start meications only after getting the results of the requested examinations. 18{\%} of Hungarian doctors do start with a non-medical therapy. Almost all responders feel that it is important to advise a reduction of weight and a cessation of smoking for GERD patients. Altering specific dietary and life-style habits was considered useful by more than 85{\%} of our responders. Hungarian physicians were more concerned about different alcoholic drinks and spicy, fatty or bloating meals and less about sweets than their German counterparts. More than 85{\%} of GPs administer some kind of drug therapy as first choice. Over 65{\%} of GPs are using the step-down approach with proton pump inhibitors as the initial strategy and 78{\%}, 76{\%}, and 81{\%} of GEs, paediatricians, and surgeons, respectively, do the same. Almost one-third of GPs and paediatricians are willing to continue therapy and almost two-thirds of GPs will reduce the dose of current medical therapy if the GERD patient is responding well to the initial therapy. Conclusions: Irrespective of the country, specialists are adhering more strictly to the guidelines on the diagnosis and treatment of GERD than general practitioners. The majority of responders, however, ask for endoscopy prior to initiation of any medication and use the step-down approach. Despite the lack of scientific evidence, reduction of weight, cessation of smoking, dietary and life-style modifications are still part of the treatment of GERD in both Germany and Hungary.",
keywords = "Diagnosis, Gastro-oesophageal reflux, GERD, Questionnaire, Therapy",
author = "I. Hritz and L. Pr{\'o}nai and F. Szalay and Z. Tulassay",
year = "2005",
month = "6",
doi = "10.1055/s-2005-858069",
language = "English",
volume = "43",
pages = "575--580",
journal = "Zeitschrift fur Gastroenterologie",
issn = "0044-2771",
publisher = "Karl Demeter Verlag GmbH",
number = "6",

}

TY - JOUR

T1 - Management of reflux disease in clinical praxis in Hungary

AU - Hritz, I.

AU - Prónai, L.

AU - Szalay, F.

AU - Tulassay, Z.

PY - 2005/6

Y1 - 2005/6

N2 - Background: Gastro-oesophageal reflux disease (GERD) is a chronic condition that affects a large proportion of the population. The majority of patients are treated in the primary care but effective management of the disease still remains a challenge for specialists as well. A recent survey - based on the case of a typical GERD patient - conducted in Germany indicated that mainly specialists adhered to the guidelines. Aim: The purpose of this study was to conduct a survey among specialists and primary care physician members of the Hungarian Society of Gastroenterology about the practical management of GERD using the same questionnaire as in the German study. Methods: A questionnaire based on the case of a typical patient with GERD was sent out to a total of 1090 members of the society. The questions concerned general measures for avoiding reflux symptoms (dietary and life-style modifications), diagnosis of GERD and the type of treatment. Answers were compared with those in the German study. Results: A total of 421 questionnaires were evaluated (38%), which had been returned by 174 general practitioners (GP), 173 gastroenterologists (GE), 41 paediatricians, and 33 surgeons. Only 9% (38/421) of the responders think that there is no necessity to carry out specific diagnostic approaches before starting any treatment. In 91% of the cases (25% always and 66% only if symptoms persist) doctors carry out specific diagnostic tests (75% endoscopy, 13% 24 hours pH-metry, and 12% X-ray). 47% of responders start drug treatment at once while 35% start meications only after getting the results of the requested examinations. 18% of Hungarian doctors do start with a non-medical therapy. Almost all responders feel that it is important to advise a reduction of weight and a cessation of smoking for GERD patients. Altering specific dietary and life-style habits was considered useful by more than 85% of our responders. Hungarian physicians were more concerned about different alcoholic drinks and spicy, fatty or bloating meals and less about sweets than their German counterparts. More than 85% of GPs administer some kind of drug therapy as first choice. Over 65% of GPs are using the step-down approach with proton pump inhibitors as the initial strategy and 78%, 76%, and 81% of GEs, paediatricians, and surgeons, respectively, do the same. Almost one-third of GPs and paediatricians are willing to continue therapy and almost two-thirds of GPs will reduce the dose of current medical therapy if the GERD patient is responding well to the initial therapy. Conclusions: Irrespective of the country, specialists are adhering more strictly to the guidelines on the diagnosis and treatment of GERD than general practitioners. The majority of responders, however, ask for endoscopy prior to initiation of any medication and use the step-down approach. Despite the lack of scientific evidence, reduction of weight, cessation of smoking, dietary and life-style modifications are still part of the treatment of GERD in both Germany and Hungary.

AB - Background: Gastro-oesophageal reflux disease (GERD) is a chronic condition that affects a large proportion of the population. The majority of patients are treated in the primary care but effective management of the disease still remains a challenge for specialists as well. A recent survey - based on the case of a typical GERD patient - conducted in Germany indicated that mainly specialists adhered to the guidelines. Aim: The purpose of this study was to conduct a survey among specialists and primary care physician members of the Hungarian Society of Gastroenterology about the practical management of GERD using the same questionnaire as in the German study. Methods: A questionnaire based on the case of a typical patient with GERD was sent out to a total of 1090 members of the society. The questions concerned general measures for avoiding reflux symptoms (dietary and life-style modifications), diagnosis of GERD and the type of treatment. Answers were compared with those in the German study. Results: A total of 421 questionnaires were evaluated (38%), which had been returned by 174 general practitioners (GP), 173 gastroenterologists (GE), 41 paediatricians, and 33 surgeons. Only 9% (38/421) of the responders think that there is no necessity to carry out specific diagnostic approaches before starting any treatment. In 91% of the cases (25% always and 66% only if symptoms persist) doctors carry out specific diagnostic tests (75% endoscopy, 13% 24 hours pH-metry, and 12% X-ray). 47% of responders start drug treatment at once while 35% start meications only after getting the results of the requested examinations. 18% of Hungarian doctors do start with a non-medical therapy. Almost all responders feel that it is important to advise a reduction of weight and a cessation of smoking for GERD patients. Altering specific dietary and life-style habits was considered useful by more than 85% of our responders. Hungarian physicians were more concerned about different alcoholic drinks and spicy, fatty or bloating meals and less about sweets than their German counterparts. More than 85% of GPs administer some kind of drug therapy as first choice. Over 65% of GPs are using the step-down approach with proton pump inhibitors as the initial strategy and 78%, 76%, and 81% of GEs, paediatricians, and surgeons, respectively, do the same. Almost one-third of GPs and paediatricians are willing to continue therapy and almost two-thirds of GPs will reduce the dose of current medical therapy if the GERD patient is responding well to the initial therapy. Conclusions: Irrespective of the country, specialists are adhering more strictly to the guidelines on the diagnosis and treatment of GERD than general practitioners. The majority of responders, however, ask for endoscopy prior to initiation of any medication and use the step-down approach. Despite the lack of scientific evidence, reduction of weight, cessation of smoking, dietary and life-style modifications are still part of the treatment of GERD in both Germany and Hungary.

KW - Diagnosis

KW - Gastro-oesophageal reflux

KW - GERD

KW - Questionnaire

KW - Therapy

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