{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,27]],"date-time":"2026-09-27T13:58:08Z","timestamp":1790517488041,"version":"4.1.0"},"reference-count":42,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2014,6,11]],"date-time":"2014-06-11T00:00:00Z","timestamp":1402444800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Neurogastroenterology Motil"],"published-print":{"date-parts":[[2014,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>There is symptom overlap between gastro\u2010esophageal reflux disease (<jats:styled-content style=\"fixed-case\">GERD<\/jats:styled-content>) and functional dyspepsia (<jats:styled-content style=\"fixed-case\">FD<\/jats:styled-content>). We aimed to test the hypothesis that <jats:styled-content style=\"fixed-case\">FD<\/jats:styled-content> cases are now more likely mislabeled as <jats:styled-content style=\"fixed-case\">GERD<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In subjects from <jats:styled-content style=\"fixed-case\">O<\/jats:styled-content>lmsted <jats:styled-content style=\"fixed-case\">C<\/jats:styled-content>ounty, <jats:styled-content style=\"fixed-case\">MN<\/jats:styled-content> seen at <jats:styled-content style=\"fixed-case\">M<\/jats:styled-content>ayo <jats:styled-content style=\"fixed-case\">C<\/jats:styled-content>linic: (i) Investigation of <jats:styled-content style=\"fixed-case\">GERD<\/jats:styled-content> and <jats:styled-content style=\"fixed-case\">FD<\/jats:styled-content> diagnosis rates between 1985 and 2009. (ii) Assessment of survey\u2010based upper gastrointestinal symptoms between 1988 and 2009. (iii) Analysis of patients reporting <jats:styled-content style=\"fixed-case\">GERD<\/jats:styled-content> and\/or <jats:styled-content style=\"fixed-case\">FD<\/jats:styled-content> symptoms and subsequently receiving a consistent diagnosis of <jats:styled-content style=\"fixed-case\">GERD<\/jats:styled-content> and\/or <jats:styled-content style=\"fixed-case\">FD<\/jats:styled-content> during a medical encounter. (iv) Assess the association between <jats:styled-content style=\"fixed-case\">PPI<\/jats:styled-content> use and <jats:styled-content style=\"fixed-case\">GERD<\/jats:styled-content> and\/or <jats:styled-content style=\"fixed-case\">FD<\/jats:styled-content> symptoms and between actual diagnoses received.<\/jats:p><\/jats:sec><jats:sec><jats:title>Key Results<\/jats:title><jats:p>(i) Yearly <jats:styled-content style=\"fixed-case\">GERD<\/jats:styled-content> diagnosis rates rose between 1985 and 2009 (325\u20131866 per 100\u00a0000). <jats:styled-content style=\"fixed-case\">FD<\/jats:styled-content> diagnosis rates rose from 45 in 1985, to 964 in 1999 but decreased to 452 per 100\u00a0000 in 2009. (ii) Reported <jats:styled-content style=\"fixed-case\">GERD<\/jats:styled-content> symptoms did not significantly change between three survey waves in the years 1988\u20132009 (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.052), whereas <jats:styled-content style=\"fixed-case\">FD<\/jats:styled-content> symptoms slightly increased (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.01). (iii) 62.9% of subjects reporting <jats:styled-content style=\"fixed-case\">GERD<\/jats:styled-content> symptoms received a <jats:styled-content style=\"fixed-case\">GERD<\/jats:styled-content> diagnosis, however only 12.5% of subjects reporting <jats:styled-content style=\"fixed-case\">FD<\/jats:styled-content> symptoms received a <jats:styled-content style=\"fixed-case\">FD<\/jats:styled-content> diagnosis. (iv) <jats:styled-content style=\"fixed-case\">PPI<\/jats:styled-content> use was associated with documented <jats:styled-content style=\"fixed-case\">GERD<\/jats:styled-content> diagnosis (<jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.001), however there was no significant association between <jats:styled-content style=\"fixed-case\">GERD<\/jats:styled-content> symptoms and <jats:styled-content style=\"fixed-case\">PPI<\/jats:styled-content> use (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.078).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions &amp; Inferences<\/jats:title><jats:p>We have found evidence supporting a systematic bias away from diagnosing <jats:styled-content style=\"fixed-case\">FD<\/jats:styled-content>, favoring a <jats:styled-content style=\"fixed-case\">GERD<\/jats:styled-content> diagnosis.<\/jats:p><\/jats:sec>","DOI":"10.1111\/nmo.12377","type":"journal-article","created":{"date-parts":[[2014,6,11]],"date-time":"2014-06-11T04:19:05Z","timestamp":1402460345000},"page":"1163-1171","source":"Crossref","is-referenced-by-count":55,"title":["Overdiagnosis of gastro\u2010esophageal reflux disease and underdiagnosis of functional dyspepsia in a USA community"],"prefix":"10.1111","volume":"26","author":[{"given":"C.","family":"Pleyer","sequence":"first","affiliation":[{"name":"Division of Gastroenterology and Hepatology Mayo Clinic Rochester MN USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H.","family":"Bittner","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology Mayo Clinic Rochester MN USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"suffix":"III","given":"G. R.","family":"Locke","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology Mayo Clinic Rochester MN USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R. S.","family":"Choung","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology Mayo Clinic Rochester MN USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A. R.","family":"Zinsmeister","sequence":"additional","affiliation":[{"name":"Division of Biomedical Statistics and Informatics Department of Health Sciences Research Mayo Clinic Rochester MN USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C. D.","family":"Schleck","sequence":"additional","affiliation":[{"name":"Division of Biomedical Statistics and Informatics Department of Health Sciences Research Mayo Clinic Rochester MN USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L. 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