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Discrepancies between upper GI symptoms described by those who have them and their identification by conventional medical terminology: A survey of sufferers in four countries

Lookup NU author(s): Emeritus Professor Amritpal Hungin



This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND).


© Copyright 2016 Wolters Kluwer Health, Inc. All rights reserved.Objective: The objective of this study was to develop a self-administered questionnaire for upper gastrointestinal (GI) symptoms using lay vocabulary uninfluenced by established medical terminology or concepts and to conduct a survey of symptom occurrence among sufferers in four countries. Methods: The questionnaire was designed by integrating information gained from the vocabulary used by 38 upper GI symptom sufferers. There was no medical input to its development. The questionnaire was then used, after appropriate translation, in Brazil, Russia, the UK and the USA. Details of 10 659 symptom episodes were obtained from 2665 individuals. Results: Nine symptoms described in lay vocabulary were identified during questionnaire development. Of these, one corresponded to regurgitation, whereas two that were distinguished by survey participants might both be interpreted as heartburn. One chest symptom for which a corresponding medical term was uncertain occurred in ∼ 30% of the respondents. Five different 'stomach' or abdominal symptoms were identified. The predominant symptom and the pattern of concurrent symptoms often varied from one symptom episode to another. Use of the terms 'heartburn', 'reflux', 'indigestion' and 'burning stomach' to describe symptoms varied between countries. Conclusion: Some common upper GI symptoms described by those who suffer them have no clear counterpart in conventional medical terminology. Inadequacy of the conventional terminology in this respect deserves attention, first, to characterize it fully, and thereafter to construct enquiry that delivers more precise symptom identification. Our results suggest that improvement may require the use of vocabulary of individuals suffering the symptoms without imposing conformity with established symptom concepts.

Publication metadata

Author(s): Heading RC, Thomas ECM, Sandy P, Smith G, Fass R, Hungin PS

Publication type: Article

Publication status: Published

Journal: European Journal of Gastroenterology and Hepatology

Year: 2016

Volume: 28

Issue: 4

Pages: 455-462

Print publication date: 01/04/2016

Online publication date: 04/03/2016

Acceptance date: 02/12/2015

Date deposited: 01/09/2017

ISSN (print): 0954-691X

ISSN (electronic): 1473-5687

Publisher: Lippincott Williams and Wilkins


DOI: 10.1097/MEG.0000000000000565

PubMed id: 26735161



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