[Epidemiology of gastro-esophageal-reflux in general practice. . Predictive factors for health care utilization in the course of a year].
AIM: To assess the epidemiology and course of GORD, treatment demand, and factors predictive of GORD course in a 1-year study in patients with heartburn consulting general practitioners. METHODS: A total of 984 patients with pyrosis were included by general practitioners. After the initial visit, they had follow up at 3, 6 and 12 months 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 patients were free of heartburn; the mean number of consultations with general practitioners and gastroenterologists was 5.1 and 0.5 respectively. At day 90, discomfort due to heartburn was absent in 4% of patients, slight in 51%, moderate in 32%, and severe in 6%. At day 360, predictive factors for discomfort were: discomfort related to heartburn on D90, the length of time the patients had been suffering from GORD, and the main reason for consultation on D1; patients for whom heartburn was not the main reason for consultation on D1 experienced a higher level of discomfort. The predictive factors for the extent of treatment demand over 12 months were: age, discomfort related to heartburn on D90, severity on D1, the frequency of episodes prior to the episode on D1 and the levels of stress and anxiety measured on D1. CONCLUSIONS: Epidemiologic characteristics of patients with heartburn consulting a general practitioner were different from these of the general population. Treatment demand depends both on severity of heartburn and level of stress and anxiety.