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Biomedical subjects

Per G Farup

Publications and source records attributed to Per G Farup.

8 recordsLinked to original sources
PubMed2006

Prevalence, comorbidity and impact of irritable bowel syndrome in Norway.

OBJECTIVE: To study the prevalence of irritable bowel syndrome (IBS) and its comorbidity in a Norwegian adult population. MATERIAL AND METHODS: In 2001, 11,078 inhabitants (aged 30-75 years) in Oppland County were invited to take part in a public health survey. A total of 4622 subjects (42%) completed the questionnaires on symptoms of IBS (Rome II criteria), comorbidity, health-care visits and medications. The impact of comorbidity on global health, working disability and use of health-care resources in subjects with IBS was explored by stepwise logistic regression. RESULTS: The population prevalence of IBS was 388/4622 (8.4% (95% CI: 7.6-9.4%)) with a female predominance and an age-dependent decrease. The proportion who had consulted for IBS ranged from 51% among 30-year-olds to 79% in 75-year-olds (p=0.05). IBS was associated with musculoskeletal complaints (OR = 2.4-3.4 for six different items), fibromyalgia (OR = 3.6 [2.7-4.8]), mood disorder (OR = 3.3 (2.6-4.3)), reduced global health (OR = 2.6 (2.1-3.2)), working disability (OR = 1.6 (1.2-2.1)), more frequent health-care visits and use of medications (OR 1.7-2.3). When controlling for comorbidity, reduced global health (OR = 1.5 (1.1-2.0)) and use of alternative health care (OR = 1.7 (1.3-2.4)) remained associated with IBS. Severity of abdominal pain/discomfort was a predictor of having to seek a physician for IBS (OR = 1.3 (1.2-1.5)). CONCLUSIONS: Symptoms of IBS were reported by 8% of Norwegian adults and had resulted in consultations with physicians for the majority in the long run. Subjects with IBS in the community were characterized by frequent somatic and psychiatric comorbidity. Their observed reduced health, working disability and increased use of health resources were largely explained by comorbid symptoms and disorders.

Adult↗
PubMed2006

Digestive symptoms and their psychosocial impact: validation of a questionnaire.

OBJECTIVE: Questionnaires evaluating digestive symptoms and their psychosocial impact have not been extensively validated in Norwegian populations. In this study a self-administered questionnaire developed in Norway is evaluated for this purpose. MATERIAL AND METHODS: The questionnaire, the Digestive Symptoms and Impact Questionnaire, DSIQ, was developed by a cooperative group of general practitioners and gastroenterologists. The DSIQ contains 18 similarly structured global-type questions focusing on the patient's own judgement. The validation was based on 567 patients with dyspeptic symptoms or reflux symptoms referred to gastroscopy from general practice. RESULTS: Eighty percent of the patients responded to all the questions. All response categories were used for all questions. Factor analysis revealed 4 subscales: abdominal pain and bowel symptoms; gastric dysfunction; health impairment and impairment of everyday life. A question about reflux symptoms was retained as a subscale on its own. Overall score was established by calculating the mean of all question responses. Test-retest reliability in stable patients (intraclass correlation coefficient, range 0.80- 0.91) and internal consistency reliability (Cronbach's alpha, range 0.65-0.91) were satisfactory. Criterion validity was supported by significant correlations to patients' globally estimated quality of life and the General Health Questionnaire (GHQ-30). Responsiveness in spontaneously improved patients or patients given effective treatment ranged from moderate to highly responsive (responsiveness statistic range from 0.54 to 2.83). CONCLUSIONS: The DSIQ is a self-administered, simple and well-validated method for evaluating digestive symptoms and their psychosocial impact. The DSIQ shows satisfactory internal consistency reliability, test-retest reliability, responsiveness and criterion validity.

Adult↗
PubMed2005

How useful are the Rome II criteria for identification of upper gastrointestinal disorders in general practice?

OBJECTIVE: The Rome II criteria are a classification of functional gastrointestinal disorders. It is not known whether they can be used as a diagnostic tool. This study evaluates the agreement between GPs and the Rome II criteria on the diagnosis of upper gastrointestinal disorders. MATERIAL AND METHODS: Consecutive patients with abdominal complaints were included in this pragmatic cross-sectional study. All patients answered a questionnaire based on the Rome II criteria. The diagnoses based on these criteria were compared with the GPs' diagnoses. RESULTS: A total of 549 consecutively selected patients were included in the study. The agreement between GPs and the Rome II criteria was 65%, kappa 0.34 (CI 0.27-0.41). The agreement was lower when dyspepsia and gastroesophageal reflux/functional heartburn were evaluated separately. The positive and negative predictive values of the Rome II criteria varied between 29-58% and 82-90%, respectively, in various groups of patients with confirmed diagnoses. CONCLUSIONS: The GPs' diagnoses differed from those based entirely on the Rome II criteria. Strict adherence to the criteria will result in other diseases being disregarded. The diagnoses of upper gastrointestinal disorders should be based on all available information and the Rome II criteria used only as an additional aid to improve the precise classification of functional disorders.

Adolescent↗
PubMed2004

Abdominal complaints in general practice.

OBJECTIVE: The study evaluates the prevalence and diagnoses of abdominal complaints in general practice, and compares characteristics and symptoms of patients with functional gastrointestinal disorders (FGIDs) and organic diseases. DESIGN: A cross-sectional study. SETTING: Nine centres with 26 participating general practitioners (GPs) in Norway. SUBJECTS: 3097 out of 3369 consecutive adult patients answered a questionnaire regarding abdominal complaints IN the last 3 months. Those who consulted for the complaints were eligible for this study. MAIN OUTCOME MEASURES: The GPs' diagnoses and patients' characteristics were reported in questionnaires. RESULTS: 460 out of 1499 patients with abdominal complaints consulted for these complaints; 392 were included in this study. The GPs diagnosed an FGID in 167 (42.6%) patients, organic disease in 145 (37.0%), and made no diagnosis in 80 (20.4%). Stress-related symptoms were a statistically significant predictor of a FGID (OR 1.95) and weight loss predicted in addition organic disease (OR 2.7) in 128 patients with a verified diagnosis. CONCLUSION: Abdominal complaints are a common problem in general practice. The distinction between FGID, which accounted for half of the diagnoses, and organic disease was difficult. The only significant predictor for FGID was stress-related symptoms.

Abdominal Pain↗
PubMed2003

[Treatment of Helicobacter pylori infection--results and experiences with an Internet-based collaboration trial].

BACKGROUND: Indications for H. pylori treatment as well as treatment regimens vary. MATERIAL AND METHODS: This trial compares three regimens with ranitidine bismuth citrate (RBC) or omeprazole as first line therapy, evaluates the effect of one regimen for retreatment, compares practice at Norwegian centres, and evaluates the utility of internet-based collaboration. Consecutive H. pylori positive outpatients at 14 centres were randomised to open treatment with one of the regimens. Patients in whom the first treatment was unsuccessful were offered an "enhanced" regimen with RBC. All participating centres submitted their data to a shared database via the internet. RESULTS: The RBC 400 mg, clarithromycin 250 mg and metronidazole 500 mg regimen, all drugs given twice daily for 7 days, was significantly more effective than the other regimens; infections in 141 out of 146 patients (97%) were successfully eradicated. An enhanced regimen with RBC, clarithromycin and metronidazole was less suitable for retreatment after failure. There were significant differences in patient age and indication for treatment between the centres. The data were of high quality. INTERPRETATION: The regimen RBC, clarithromycin and metronidazole was the most effective and seems suitable as first-line treatment. The internet collaboration yielded data of high quality that disclosed that patients were not uniformly managed. Our collaborative approach seems to be a suitable method for quality assurance and the organisation of simple clinical multicentre trials.

Adult↗
PubMedDate not supplied

The effect of Helicobacter pylori retreatment with ranitidine bismuth citrate, clarithromycin, and metronidazole depends on the first-line therapy.

BACKGROUND: Helicobacter pylori eradication rates seem to decrease. This study evaluates the effect of retreatment with ranitidine bismuth citrate (RBC) 400 mg B.I.D., clarithromycin (C) 500 mg B.I.D., and metronidazole (M) 500 mg every morning and 1,000 mg every evening for 14 days [RBC.C.M]. STUDY: Nine gastroenterologic units included patients with unsuccessful eradication of H. pylori in a preceding randomized trial. Previous treatment was either omeprazole (O) 20 mg, C 250 mg, and M 500 mg [O.C.M] or RBC 400 mg, tetracycline (T) 1,000 mg, and M 500 mg [RBC x T x M]; all drugs were given twice daily for 7 days. RESULTS: Twenty-six H. pylori-positive patients were included (nine males, 17 females; mean age, 54 years; range, 39-74 years). The eradication rates in the groups previously treated with O.C.M and RBC.T.M were three of nine (33%) (95% CI = 12-65) and 15 of 17 (88%) (95% CI = 66-97) respectively (p = 0.008). The corresponding results in a "per-protocol" analysis were three of eight (38%) (95% CI = 13-69) and 10 of 10 (100%) (95% CI = 72-100), respectively (p = 0.007). A side effect score was 21.8 compared with 8.3 in the previous study (p < 0.001). CONCLUSIONS: The effect of a retreatment regimen depends on the preceding treatment. The RBC x C x M regimen is effective in nonresponders to RBC x T x M, but it seems unsuitable after failure of the O x C x M regimen.

Adult↗