Gastroskopie deur 'n Huisarts - 'n Ontleding van 1600 Ondersoeke/ Gastroscopy by a Family Physician - an analysis of 1600 procedures

Abstract

This ia a review of the findings in a series of 1600 gastroscopic examinations done by a family practitioner who has had the necessary training for it. Results are compared with similar studies abroad. The general practice where these examinations were done, consists of six partners in a rural hospital town where there are no practicing specialists. Data collected were age and sex of the patients, previous history, presenting symptoms, clinical findings, gastroscopic findings, and complications of the procedure. Distribution between the sexes was practically even. The commonest symptom was epigastric pain (81%). The commonest gastroscopic findings were gastriis, haitus hernia and duodenitis. Complications due to the procedure where minimal. Paitens found it less unpleasant to be investigated at their own doctor's consulting rooms. Cost effective utilisation of gastroscopy to make a definite diagnosis is of special importance because of the poor correlation between clinical finding and gastroscopic diagnosis. A distinct advantage of gastroscopic diagnosis, after the necessary selection for examination, is the avoidance of unnecessary, expensive empiric treatment with eg H2 antagonists. Guidelines are discussed regarding correct indications for gastroscopy and how to keep the rate of the re-examinations low. Family practitioners should perform gastroscopies themselves only when strict prerequisites are adhered to.