One-year prognosis of abdominal complaints in general practice: a prospective study of patients in whom no organic cause is found.

BACKGROUND: Data on the one-year prognosis of patients with non-organic, non-acute abdominal complaints in primary care are lacking. Knowledge of prognostic determinants could be helpful in management and health education.

AIM: To describe the prognosis after one year of non-organic abdominal complaints in general practice, and to show how this relates to socio-demographic factors, medical history and psychological problems.

METHODS: The one-year prognosis of patients with non-organic abdominal complaints in a primary care setting was analysed in a prospective study (n = 756). Clinical and psychological factors were measured and their relative risks regarding unfavourable prognosis were calculated one year after the first consultation.

RESULTS: In 68% of the patients examined, the abdominal complaints had either improved or disappeared by the end of the first year. Female sex and depressive mental state were associated with an unfavourable prognosis. Clinical symptoms that were significantly associated with persisting complaints were a combination of abdominal pain, flatulence and bowel irregularities; a specific description of the character of the pain by the patient; looser stools at the onset of the pain; long duration or recurrence, pyrosis; absence of visible distension; and epigastric localization of the pain or tenderness.

CONCLUSIONS: The prognosis after one year of non-acute abdominal pain in general practice is better than that reported from studies of outpatient populations. Female sex, depressive mood and some clinical parameters are associated with persistent complaints one year after presentation.