First-time endoscopy and use of antisecretory medication: A population-based cohort study

Abstract

Objective Endoscopy is the gold standard for diagnostic evaluation of upper gastrointestinal symptoms. The relation between endoscopy and use of antisecretory medication on a population level is unknown. The aim of this study was to describe development in the number of patients undergoing first-time endoscopies and their use of antisecretory medication. Material and methods Data on the use of endoscopies and antisecretory medication (H₂ blockers and proton-pump inhibitors) were extracted from five population-based databases and included all citizens in Funen County (population 470,000) who had first-time endoscopies between 1993 and 2002. Results A total of 27,829 first-time endoscopy patients were identified. In 2002 the number of first-time endoscopies was 5.6/1000 persons. The proportion that had redeemed prescription(s) on antisecretory medication the last year before endoscopy increased from 33% (1095/3286) in 1993 to 41% (1012/2445) in 2002 (p=0.000). Following endoscopy, average use of antisecretory medication increased by 90 defined daily doses (DDD)/patient/year (95% CI 84–96) in patients with oesophagitis (N=4850), by 59 DDD/patient/year (95% CI 54–64) in peptic ulcer patients (N=4373) and by 18 DDD/patient/year (95% CI 16–20) in patients with normal endoscopies (N=16,400). Conclusions An increasing proportion of patients are treated with antisecretory medication before endoscopy. Following endoscopy, use of antisecretory medication increases irrespective of the diagnostic findings.

• Anti-ulcer
• cohort study
• endoscopy
• medication
• oesophagitis
• peptic ulcer