Diagnostic work-up of rectal bleeding in general practice.
Br J Gen Pract
; 55(510): 14-9; discussion 18, 2005 Jan.
Article
en En
| MEDLINE
| ID: mdl-15667760
ABSTRACT
BACKGROUND:
GPs have many patients with gastrointestinal discomfort. Among bowel-related complaints, the sign of rectal bleeding is of particular importance in patients aged 50 years and above, as it can be an early sign for serious bowel diseases such as colon carcinoma. Despite many guidelines offered to GPs for screening and early detection of colorectal carcinomas, there is very little information about the actual diagnostic approach to the sign of rectal bleeding.AIM:
The aim of the study was to collect data concerning treatment strategies used by GPs who treat patients presenting with rectal bleeding. DESIGN OF STUDY Prospective data collection.SETTING:
General practices in Germany.METHOD:
Over the course of a year, GPs recorded their treatment strategies in patients presenting with rectal bleeding and associated symptoms. Using a digital practice patient file, physicians participating in the study were able to continuously transmit data electronically to the researchers of the study about diagnostics, referrals, hospital admissions, and final diagnoses.RESULTS:
During the course of 1 year, 94 participating physicians collected data on 1584 patients. Information about treating rectal bleeding was recorded for 422 patients; 60% of the patients were referred to specialists in internal medicine or gastroenterologists for further diagnostics. A colonoscopy was the most frequently performed diagnostic procedure (46.2%). Twenty-two per cent (n = 93) of the patients--54 of them aged 50 years and above--were exclusively treated by their GP without conducting a colonoscopy or cooperating with specialists. For these patients, GPs diagnosed less severe diseases like haemorrhoids or other proctologic diseases.CONCLUSION:
By using a study that allows GPs to transmit electronically their findings and data, it is possible to draw a picture of treatment strategies of GPs in patients presenting with rectal bleeding. The high percentage of patients who received medical treatment in consultation with specialists underscores the significance of the sign of rectal bleeding in general practice. The need for further diagnostic measures in patients who have been treated exclusively by GPs has to be discussed.
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Hemorragia Gastrointestinal
Tipo de estudio:
Diagnostic_studies
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Etiology_studies
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Guideline
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Observational_studies
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Risk_factors_studies
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Screening_studies
Límite:
Adult
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Aged
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
Br J Gen Pract
Año:
2005
Tipo del documento:
Article
País de afiliación:
Alemania