Prevalence of functional disorders of the upper gastrointestinal tract and related consultation behaviour in an urban community from Eastern Turkey

Yıl 2007, Cilt: 6 Sayı: 1, 3 - 9, 01.04.2007

Selman Çelebi S. Erhan Deveci Hüseyin Ataseven Mehmet Yalnız İ. Halil Bahçecioğlu Yasemin Açık

Öz

Background/aims: Functional disorders of the upper gastrointestinal tract are common in the general population, but there is limited data on the epidemiology of the functional gastrointestinal disorders (FGID) in Turkey. The aim of the present study was to assess the prevalence of upper FGID symptoms and related consultation behavior in an urban population in the eastern part of Turkey. Materials and methods: An age- and sex-stratified random sample of community subjects (n = 933), aged 18 years and over, was drawn from the records of health care centers in the eastern Turkish city of Elazig. A detailed questionnaire assessing their upper GI symptoms and related consultation behavior was completed by the subjects (n=810). Symptoms of the upper FGID were classified according to Rome II criteria. Statistical analyses were performed using chi-square and Student's t test. Logistic regression analysis was performed to explore the association between the presence of upper FGIDs, consultation behavior and demographics. Results: 810 subjects with suitable responses for analysis were included in the survey. 43.6% of all participants had at least one upper FGID, while 9% reported more than one. Symptoms were localized as esophageal (34.6%), gastroduodenal (14.6%) and biliary (1.9%). Of the total subjects with FGID, 24.6% had consulted a doctor due to these symptoms within the previous year. Logistic regression analysis revealed that independent predictors for having an upper FGID are increasing body mass index (BMI) and lower educational level, and for consultation is advanced age. Conclusions: Upper FGIDs are a problem in an urban population in Turkey, with a prevalence of almost half of the population. Frequency of GI symptoms is associated with lower education. Obesity is a risk factor especially for functional heartburn. Advanced age was determined to be the most predictive factor for low level of health care consultation for GI symptoms.

Anahtar Kelimeler

Epidemiology, consultation behavior, functional gastrointestinal disorders, upper gastrointestinal tract, Turkey

Elazığ şehir toplumunda fonksiyonel üst gastrointestinal bozuklukların prevalansı ve sağlık yardımı arama

Öz

Giriş ve amaç: Batı ülkelerinde genel popülasyonda üst gastrointestinal (Gİ) semptomlar yaygındır. Ülkemizde üst Gİ sistemin fonksiyonel bozuklukları ile ilgili bilgi sınırlıdır. Bu çalışma bir Doğu Anadolu şehir toplumunda özofageal, gastroduodenal ve biliyer fonksiyon bozukluklarının prevalansını ve sağlık yardımı arama davranışını incelemek amacıyla yapılmıştır. Gereç ve yöntem: Elazığ'da bulunan 18 sağlık ocağından randomize seçilen dördünde kayıtlı 18 ve üstü yaştaki sağlıklı bireyler arasından 933 kişi randomize seçildi. Sağlık ocaklarında görevli hemşireler tarafından belirlenen kişilere ulaşılarak Roma II kriterlerine göre düzenlenmiş bir anket formu dağıtıldı. Boy, ağırlık, demografik bilgiler, alarm semptomlar ve önceki tanıları kaydedildi. İstatistik analiz ki-kare, regresyon analizi ve t testi ile yapıldı. Bulgular: 933 anketten 810'u çalışmaya alındı (%87). Bireylerin %47.5'i kadın, %52.5'i erkek, yaş ortalamaları sırasıyla 36.5 ve 35.3 yıl idi. Eğitim seviyesi kadınlarda erkeklere göre (p=0.001) daha düşüktü. Globus %1.9, ruminasyon %2.2, göğüs ağrısı %4.8, fonksiyonel yanma %25.4, disfaji %3, fonksiyonel dispepsi %4.2, aerofaji %9.6, kusma %1.5, safra kesesi disfonksiyonu %1.6 ve Oddi sfinkter disfonksiyonu %0.2 oranında bulundu. Biliyer kanal semptomları kadınlarda erkeklere göre anlamlı olarak daha yüksekti. Popülasyonun %43.6'sında en az bir, %9'unda birden fazla Gİ bozukluk vardı. Özofageal semptomlar ileri yaş ve yüksek vücut kitle indeksi ile ilişkiliydi. Gİ semptomlar düşük eğitim grubunda anlamlı olarak daha yüksek oranda bildirildi. Semptomlar nedeniyle doktora başvurma oranı %24.6 olup, kadınlarda erkeklere göre ve ileri yaşlarda genç yaşlara göre belirgin olarak daha yüksekti. Sonuç: Üst Gİ kanalın fonksiyonel bozuklukları toplumumuzun yarısına yakınını etkileyen yaygın bir problemdir. Gİ semptom sıklığı düşük eğitim seviyesi ile ilişkilidir. Obezite özellikle fonksiyonel yanma için bir risk faktörüdür. Gİ semptomlar nedeniyle sağlık yardımı arama oranı düşüktür ve ileri yaş bunda en önemli faktördür.

Anahtar Kelimeler

Epidemiyoloji, doktora başvurma, fonksiyonel gastrointestinal bozukluklar, üst gastrointestinal semptomlar, Türkiye

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