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Doctors Show Bias When Diagnosing Stomach Problems


ROCHESTER, Minn.—Patients who complain of upper gastrointestinal (GI) symptoms often face a diagnosis of either gastroesophageal reflux disease (GERD) or functional dyspepsia. Because the two conditions often overlap, it can be difficult to distinguish between them and diagnose them properly. Yet ambulatory care facilities and hospitals have reported a dramatic increase in the number of GERD-related visits/discharges in recent years.

This led a team of researchers at Mayo Clinic, others from the United States, Europe and Australia to question if “observer bias” plays a role in the diagnosis of GERD, compared to a diagnosis of functional dyspepsia. As reported recently during the American College of Gastroenterology 2011 Annual Scientific Meeting and Postgraduate Course, such a bias exists and increases the likelihood of a diagnosis of GERD. This theory is supported by the following findings from the study:

* In the last 20 years, the number of GERD diagnoses has increased despite a simultaneous decrease in GERD symptoms.

* In the presence of both functional dyspepsia and GERD symptoms, GERD is diagnosed most commonly.

* GERD is the most likely diagnosis in the presence of functional dyspepsia symptoms only.

“These findings serve as a reminder to all physicians to keep an open mind when patients complain of upper GI pain,” said senior author G. Richard Locke, MD, a Mayo Clinic gastroenterologist. “It is worth considering every possible cause of the symptoms, including the sometimes challenging-to-treat functional dyspepsia. Plus, if we believe the patient’s symptoms are caused by GERD, we must confirm that diagnosis.”

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