CONTROVERSY AND CONSENSUS IN THE MANAGEMENT OF UPPER GASTROINTESTINAL-DISEASE IN PRIMARY-CARE

Approximately 5% of all primary care consultations in the UK are for u pper gastrointestinal (GI) diseases, the most common of which is dyspe psia, with a prevalence of between 25 and 50% in the western world. Th e exact definition of dyspepsia is elusive, which has resulted in conf usion about diagnosis and treatment, highlighting the need for managem ent guidelines. The International Gastro Primary Care Groups (IGPCG) h as developed, by consensus, practical guidelines to help GPs manage pa tients with upper GI symptoms. After a detailed history is taken, alar m symptoms identified and organic disease excluded, the predominant sy mptom should be identified. This strategy, as outlined in the IGPCG up per GI disease management plan, can help the GP in the selection of th e most appropriate treatment for each patient. This plan is flexible e nough to be used in a wide variety of healthcare systems and will evol ve as new evidence becomes available.