Dilek OĞUZ, Aydın Şeref KÖKSAL, Ali ÖZDEN

Türkiye'de birinci basamak sağlık kurumlarına başvuran hastalarda gastroözofageal reflü hastalığı görülme sıklığı

Giriş ve Amaç: Gastroözofageal reflü hastalığı, gastrointestinal sistemin sık görülen hastalıklarından birisi olup, prevalansı çalışmanın yapıldığı topluma göre değişmektedir. Türkiye'de gastroözofageal reflü hastalığı epidemiyolojisi hakkında sınırlı bilgi vardır. Bu çalışma da Türkiye'de birinci basamak sağlık kuruluşlarına başvuran hastalarda gastroözofageal reflü hastalığı sıklığını saptamak ve epidemiyolojik özelliklerini belirlemek amaçlanmıştır. Gereç ve Yöntem: Çalışma Türkiye'nin 32 farklı ilindeki birinci basamak sağlık kuruluşlarına başvuran olgular arasından rasgele seçilen 7520 olguda gerçekleştirilmiştir. Hastalar başvurudaki ana yakınmalarına göre gastrointestinal sistem ve gastrointestinal sistem dışı semptomlarla başvuranlar olmak üzere iki guruba ayrıldıktan sonra, her iki gurup içinden rastgele seçilen 2203 olguya yüz yüze görüşülerek anket yapılmış ve gastroözofageal reflü hastalığı prevalansı ve epidemiyolojik özellikleri araştırılmıştır. Gastroözofageal reflü hastalığı tanısı Roma-II kriterlerine göre konulmuştur. Bulgular: Çalışmaya katılan 7520 hastanın 2157'si (%31.5) gastrointestinal sistem semptomları ile doktora başvururken, 5363'ü (%68.5) gastrointestinal sistem dışı yakınmalar ile başvurmuştur. Gastrointestinal sistem yakınmaları ile başvuran 2157 hasta arasından rasgele anket yapılan 1461 olgunun 560'ında (%38.3), gastrointestinal sistem dışı yakınmalar ile başvuran 5363 olgu arasından rasgele anket yapılan 742 olgunun 189'unda (%25.4) gastroözofageal reflü hastalığı tanısı konulmuştur. Gastroözofageal reflü hastalı ğı prevalansı %33.9 olarak bulunmuştur. Hastaların çoğunluğu kadın olup (%69.3), yaş ortalaması 44±14 yıldır. Retrosternal yanma (%60.1), regürjitasyon (%59.1), retrosternal ağrı (%35.5) ve öksürük (%27.6) en sık görülen yakınmalardır. Hastaların %16.6'sı retrosternal yanmayı ayda bir, %30'u haftada bir, %39.5'i haftada birden fazla, %13.9'u her gün yaşadığını ifade etmektedir. Medeni durum, çay, sigara, kahve ve alkol kullanımı ile gastroözofageal reflü hastalığı arasında istatistiksel anlamlı bir ilişki bulunmamıştır. Ekonomik durum (p < 0,01) ve eğitim düzeyi (p < 0,01) ile gastroözofageal reflü hastalığı arasında anlamlı pozitif bir korelasyon vardır. Sonuç: Sonuç olarak, ülkemizde gastroözofageal reflü hastalığı batılı ülkelerde rastlanan sıklığa yakın oranlarda görülmekte olup retrosternal yanma ve regürjitasyon başvuruda en sık rastlanan şikayetler olarak ortaya çıkmaktadır.

Anahtar Kelimeler:

Gastroözofageal reflü, prevalans, birinci basamak, Türkiye

The frequency of gastroesophageal reflux disease in patients admitting to primary health care centers in Turkey

Background and Aims: Gastroesophageal reflux disease is a common gastrointestinal disorder and its prevalence differs depending on the population studied. There are few data on the epidemiology of gastroesophageal reflux disease in Turkey. The aim of the study was to determine the frequency and epidemiologic features of gastroesophageal reflux disease in patients admitting to primary health care centers in Turkey. Materials and Methods: The study was carried out in a population of 7520 patients randomly selected among those admitted to primary health care centers in 32 different cities in Turkey. Patients were categorized into two groups [gastrointestinal system or non- gastrointestinal system] depending on the main symptoms on admission. The prevalence and epidemiologic features of gastroesophageal reflux disease were investigated via face-to-face questionnaire to a total of 2203 randomly selected patients from both of the groups. The diagnosis of gastroesophageal reflux disease was based on the Rome-II criteria. Results: Among the 7520 patients participating in the study, 2157 (31.5%) were admitted with gastrointestinal system symptoms and 5363 (41%) with non- gastrointestinal system symptoms. Of the 2157 patients with gastrointestinal system symptoms, the questionnaire was administered in a randomly selected 1461 patients and a diagnosis of gastroesophageal reflux disease was reached in 560 (38.3%). Of the 5363 patients with non- gastrointestinal system symptoms, a questionnaire was administered in a randomly selected 742 patients and a diagnosis of dyspepsia was reached in 189 (25.4%). The prevalence of dyspepsia was 33.9% in the whole group. Most of the patients were female (69.3%) and the mean age was 44 ± 14 years. Heartburn (60.1%), regurgitation (59.1%), retrosternal pain (35.5%) and cough (27.6%) were the most frequent symptoms. Sixteen percent of the patients experienced heartburn once a month, 30% once a week, 39.5% more than once a week, and 13.9% daily. There were no significant associations between gastroesophageal reflux disease and marital status, smoking, or tea, alcohol and coffee consumption. Economic status (p

Keywords:

Gastroesophageal reflux, prevalence, primary care, Turkey,

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