Controversy and consensus in the management of upper gastrointestinal disease in primary care. The International Gastro Primary Care Group.

Approximately 5% of all primary care consultations in the UK are for upper gastrointestinal (GI) diseases, the most common of which is dyspepsia, with a prevalence of between 25 and 50% in the western world. The exact definition of dyspepsia is elusive, which has resulted in confusion about diagnosis and treatment, highlighting the need for management guidelines. The International Gastro Primary Care Groups (IGPCG) has developed, by consensus, practical guidelines to help GPs manage patients with upper GI symptoms. After a detailed history is taken, alarm symptoms identified and organic disease excluded, the predominant symptom should be identified. This strategy, as outlined in the IGPCG upper GI disease management plan, can help the GP in the selection of the most appropriate treatment for each patient. This plan is flexible enough to be used in a wide variety of healthcare systems and will evolve as new evidence becomes available.