[The value of symptoms in the diagnosis of peptic ulcer: an approximation to the primary care medium]. / Valor de los síntomas en el diagnóstico de la úlcera péptica: una aproximación al medio primario.

GOAL: To evaluate which clinical data are useful to select those patients with peptic ulcers in primary care most likely to benefit from complementary studies. METHODS: This is a prospective study done on 101 patients evaluated in a period of a year in a Primary Care Center. In all patients an endoscopy was done when a peptic ulcer was considered a possibility. In all cases a standardized questionnaire was completed before endoscopy and the patient evaluated by his primary care physician. The final diagnosis was defined according to endoscopy, done by expert endoscopists within seven days of the clinical evaluation. Statistical analysis was undertaken with SPSS software. RESULTS: An active peptic ulcer was found in 45 (44.5%) cases. A high-grade MALT lymphoma was diagnosed in one case. Male sex, smoking status, number of cigarettes, smoking-index, and a previous history of ulcer complications were significantly associated with the diagnosis, as well as severe diurnal or nocturnal pain. Mean age was lower in ulcer patients. However no clinical data in individual or combined form did show any predictive value. CONCLUSIONS: Clinical data do not permit to obviate endoscopy as the key initial procedure to diagnosis, even in primary care.