Early relief of upper XXXX : a survey of empirical therapy with @entity10112 in Canadian clinical practice.

@entity1 @entity390 @entity1109 @entity344 @entity10112 @entity354 @entity158 @entity360
BACKGROUND: @entity344 attributable to @entity354 or peptic ulcer are common, but the outcome of proton pump inhibitor therapy in clinical practice is not well documented. AIM: To assess the range of upper gastrointestinal acid-related symptoms in clinical practice and the rapidity of their response to @entity10112 (40 mg daily), after seven days of therapy. METHODS: A total of 726 Canadian physicians (65.3% family physicians) recorded a working diagnosis and alarm features in eligible @entity1 , who then recorded the severity of eight @entity344 in a daily symptom diary during the first week of therapy. RESULTS: Complete data were obtained from 2273 (37.3% male) of 3261 @entity1 ; physicians diagnosed @entity354 alone (66.9%), peptic ulcer (9.7%), other @entity344 (12.3%) and @entity354 with another diagnosis (11.1%). Alarm features were common (29.6%), but a history of @entity360 was rare (less than 1%). Mean daytime heartburn scores decreased from 2.59 to 1.40, and @entity158 scores decreased from 2.54 to 1.56 over the first week (P<0.00001); the proportions of @entity1 who became symptom-free were 68.1% and 55.4%, respectively. Decreased mean symptom scores were also observed for acid regurgitation (2.21 to 1.35), bloating (2.47 to 1.57), @entity390 (2.03 to 1.36), slow digestion (2.51 to 1.56) and burping (2.56 to 1.69). The percentage of @entity1 with severe or very severe symptoms decreased from 53.5% to 13.8% at day 7. The physician's initial diagnosis was not predictive of outcome. CONCLUSIONS: In a predominantly primary care population with upper gastrointestinal acid-related symptoms, proton pump inhibitor therapy produces prompt symptomatic relief in most @entity1 . @entity1109 are common, and further research is required to determine the absolute risk of alarm symptoms and their implications for empirical therapy.
