Perceptions and beliefs concerning gastroesophageal reflux disease: Physicians and patients disagree

Background/Aim: There is insufficient evidence to support an association between lifestyle and gastroesophageal reflux disease (GERD). Furthermore, perceptions concerning the impact of GERD on lifestyle are largely unknown. We aimed at investigating physicians' perceptions about GERD and lifestyle and at evaluating physician-patient agreement concerning the impact of GERD on the quality of life. Methods: A questionnaire was mailed to all Danish primary care physicians (n = 3,603, response rate 36%) and to all Danish gastroenterologists (n = 624, response rate 50%). Another questionnaire was completed by 176 GERD patients on medical therapy (84% on proton pump inhibitors). Results: 35% of the physicians believe GERD is predominantly caused by lifestyle and 51% always recommend lifestyle modifications. According to the physicians, the three most frequently affected aspects of quality of life were sleep disturbances (24%), limitations in physical activities (22%) and tiredness (18%). However, according to the patients, the three most frequently reported aspects were dietary restrictions (63%), tiredness/lack of energy (49%) and health concerns (44%). 70% of the physicians considered complete absence of symptoms as a useful goal for therapy. 72% of the patients reported recent symptoms, despite therapy and self-imposed lifestyle restrictions. Conclusions: Physicians and GERD patients disagree on impairments of quality of life. Many patients reported frequent symptoms despite therapy and self-imposed lifestyle restrictions.