Gaps in awareness and clinical practices regarding GERD among healthcare physicians in Pakistan

Abstract

Objective: To assess the knowledge, understanding, clinical practices, and challenges of physicians in Pakistan concerning Gastroesophageal reflux disease (GERD), and to identify areas for improvement to enhance patient outcomes.

Methodology: This cross-sectional survey was conducted among 435 physicians across Pakistan, including general practitioners, gastroenterologists, and internal medicine specialists. A structured, self-administered questionnaire collected data on demographics, knowledge of GERD risk factors and symptoms, diagnostic practices, management approaches, and perceived challenges.

Results: Among 435 surveyed physicians, 80.2% reported being very familiar with GERD diagnosis and management, yet there were notable gaps in recognizing atypical and extra-esophageal symptoms. While acid regurgitation (91.5%) and heartburn (82.8%) were the most commonly recognized symptoms, less frequent acknowledgment was found for dysphagia (42.8%), cough (47.6%), and sore throat (37.7%). Only 14.0% of respondents consistently considered extra-esophageal symptoms in the context of GERD. Additionally, risk factors such as diet (82.3%), obesity (78.9%), and smoking (77.5%) were widely recognized, but challenges like poor treatment adherence (73.1%) and medication costs (46.0%) were reported. A majority of respondents requested more training (61.8%) and availability of updated national guidelines (57.2%). These findings highlight gaps in symptom recognition and the need for enhanced education and research to improve GERD diagnosis and management practices.

Conclusion: While most physicians demonstrated adequate knowledge of GERD, significant gaps in recognizing atypical symptoms, utilization of advanced diagnostics, and addressing management challenges were noted. Tailored interventions, including updated national GERD guidelines, focused training programs, and enhanced access to diagnostic and management tools, are essential to improving care quality and patient outcomes in Pakistan.