DIAGNOSTIC EVALUATION OF PATIENT WITH DYSPEPSIA SYNDROME AND HEARTBURN BY GP AND PRIMARY CARE PHYSICIAN: NEED OF A NEW & SIMPLE QUESTIONNAIRE

Lazebnik L. B.1, Lyalyukova Е. А.4, Alexeenko S. A.2, Samsonov А. А.3, Serebrova S. Yu.6, Tsukanov V. V.5, Kareva E. N.6, 7

 Objective: To review international evidences available on the use of various questionnaires in primary care for patients with upper gastrointestinal symptoms; to analyze sensitivity and specifi city of these tools in predicting diagnosis of gastroesophageal refl ux and dyspepsia; to seek opportunities for implementation of the questionnaires into routine clinical practice in Russia.

Literature review: Available data are suggestive that modifi ed version of frequency scale for the symptoms of gastrointestinal refl ux disease (mFSSG) consists specifi c questions refl ecting symptoms of refl ux and dyspepsia which can be measured in form of Refl ux Score (RS) and Dyspepsia Score (DS). By calculating this individual score, it has high positive eff ect on the pre-investigational identifi cation of Gastrointestinal Refl ux Disease and Dyspepsia syndrome respectively. Beyond the signifi cant sensitivity and specifi city, mFSSG tool is very convenient for practical use. When DS score is ranged between 6 and 8, the greatest correlation is observed with the fact that clinical criteria for functional dyspepsia are met by patient: lower DS scores are not indicative for starting empirical treatment of dyspepsia. DS score of 8 and above should be regarded as suffi cient for the initiation of empirical treatment of uninvestigated dyspepsia. 

Recommendations: This review recommends using mFSSG questionnaire in the complex diagnostic examinations of patients who have symptoms of gastroesophageal refl ux and/or dyspepsia. Those patients with uninvestigated dyspepsia who have mFSSG dyspepsia score of 8 and above can be recommended empiric treatment with fi xed dose combination of omeprazole 20mg and domperidone suspended release 30mg. Russian version of the questionnaire yet to be validated in Russian patients population. 

Conclusion: This review provides practical recommendations on using mFSSG questionnaires by GPs and primary care physicians for making preliminary diagnostic decisions, identify laboratory examinations to be required, and to decide empiric treatment administration for patients with upper gastrointestinal symptoms. mFSSG questionnaire is meant to assist with, not dictate, decision making in conjunction with patients.