Epidemiology of gastro-esophageal reflux. Predictive factors for health care resource consumption during one year

Aim - To assess the epidemiology and course of CORD treatment demand, and f actors predictive of GORD course in a 1-year study in patients with heartbu rn consulting general practitioners. Methods - A total of 984 patients with pyrosis were included by general pra ctitioners. After the initial visit, they had follow up at 3, 6 and 12 mont hs by phone contact. Results - Most patients (87%) had been suffering from heartburn for 4+/-1.5 years; upper GI endoscopy had been performed in 63% of patients. Patients evaluated the symptoms of the current episode as mild (6%), moderate (60%), or severe/incapacitating (34%). During the year of follow up, 12% of the p atients were free of heartburn; the mean number of consultations with gener al practitioners and gastroenterologists was 5.1 and 0.5 respectively. At d ay 90 discomfort due to heartburn was absent in 4% of patients; slight in 5 1% moderate in 32%, and severe in 6%. At day 360 predictive factors for dis comfort were: discomfort related to heartburn on D90, the length of time th e patients had been suffering from GORD, and the main reason for consultati on on D1; patients for whom heartburn was not the main reason for consultat ion on D1 experienced a higher level of discomfort. The predictive factors for the extent of treatment demand over 12 months were: age, discomfort rel ated to heartburn on D90, severity on D1, the frequency of episodes prior t o the episode on D1 and the levels of stress and anxiety measured on D1. Conclusions - Epidemiologic characteristics of patients with heartburn cons ulting a general practitioner were different from these of the general popu lation. Treatment demand depends both on severity of heartburn, and level o f stress and anxiety.