The management of common gastrointestinal disorders in general practice A survey by the European Society for Primary Care Gastroenterology (ESPCG) in six European countries

Dig Liver Dis. 2008 Aug;40(8):659-66. doi: 10.1016/j.dld.2008.02.020. Epub 2008 Apr 11.


Background: Gastrointestinal (GI) disorders account for 10% of all consultations in primary care. Little is known about the management of GI disorders by general practitioners (GP) across different European countries.

Aim and methods: We undertook a postal survey of randomly selected samples of GPs in six European countries (UK, Holland, Spain, Greece, Poland, Czech Republic) to determine patterns of diagnosis, management and service use in GI disorders.

Results: We received 939 responses, response rate 32%. Over 80% of GPs were aware of at least three national guidelines for gastrointestinal disease. The availability of open access endoscopy ranged from 28% (Poland) to over 80% (Holland, Czech and UK). For uninvestigated dyspepsia the preferred first line management was proton pump inhibitor therapy (33-82%), Helicobacter pylori test and treat (19-47%), early endoscopy (5-32%), specialist referral (2-21%). Regarding irritable bowel syndrome, 23% of respondents were familiar with one or more diagnostic criteria, but between 7% (Netherlands) and 32% (Poland) would ask for a specialist opinion before making the diagnosis.

Conclusion: The wide variation between GPs both between and within countries partly reflects variations in health care systems but also differing levels of knowledge and awareness, factors which are relevant to educational and research policy.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Endoscopy, Gastrointestinal / statistics & numerical data
  • Europe
  • Gastrointestinal Diseases / diagnosis*
  • Gastrointestinal Diseases / therapy*
  • Health Care Surveys
  • Humans
  • Middle Aged
  • Physicians, Family / statistics & numerical data*
  • Practice Guidelines as Topic
  • Practice Patterns, Physicians' / statistics & numerical data*
  • Proton Pump Inhibitors / therapeutic use
  • Referral and Consultation / statistics & numerical data
  • Surveys and Questionnaires


  • Proton Pump Inhibitors