Gastrointestinal symptoms in Ireland, North and South — a survey of general practitioners

• Project start date: 1 March 2002
• Project status: Completed
• Project type: Food safety
• Discipline: Microbiology and food hygiene
• Author/s: Dr Margaret Fitzgerald, Food Safety Authority of Ireland, Dublin
• Collaborator/s: Prof Leslie Daly, Dr Dominique Crowley & Claire Collins, University College Dublin, Mr Tom Robinson, Food Standards Agency Northern Ireland, Belfast, Dr Brian Smyth, Communicable Disease Surveillance Centre, Belfast, Dr Derval Igoe, Health Protection Surveillance Centre, Dublin

Research objective

The primary objective of the "Acute Gastroenteritis in Ireland, North and South" project was to gain comprehensive insights into the prevalence, management, and impact of acute gastroenteritis (AGE) across the island. This initiative sought to understand the frequency and characteristics of AGE, assess healthcare-seeking behaviours, and examine the clinical practices of general practitioners (GPs). The project aimed to inform public health policy and preventative measures, particularly regarding foodborne-related illnesses, by collaborating with key stakeholders in both Northern Ireland and the Republic of Ireland.

Research report

• Title: Acute Gastroenteritis in Ireland, North and South - A Study of General Practitioners
• Date: 6 February 2003
• Summary: The research focused on assessing the burden of acute gastroenteritis (AGE) in Ireland, North and South, through two main studies. The first study conducted a telephone survey of nearly 10,000 participants to estimate AGE frequency and its impact on work and school attendance. The second study surveyed over 1,000 GPs to understand clinical management practices and notification processes. The studies utilised quantitative and qualitative methods, including interviews, focus groups, and postal surveys, conducted over periods from December 2000 to November 2001 and Autumn 2002, respectively.
• Findings:

  AGE Prevalence: 4.5% of the population reported AGE in the previous four weeks, equating to 3.2 million episodes annually.
  Healthcare Seeking: 29.2% sought medical care; 1.3% visited A&E; 1.8% were hospitalised.
  Impact: 17.4% took time off work, averaging 2.7 days, leading to significant economic losses.

  GP Management:

  • 93% advised extra fluids.
  • There was less consensus on anti-diarrhoeal use; younger GPs and women were less likely to prescribe them.
  • Limited antibiotic prescription, typically with microbiologist consultation.
  • GPs selectively requested stool samples based on illness severity and suspicion of foodborne illness.
  • Low notification rates, particularly in Ireland due to concerns about patient confidentiality and unclear pathways.
• Recommendations:
  1. Develop clinital guidelines for anti-diarrhoeal and antibiotic use.
  2. Establish stool and clinical specimen collection services in Ireland.
  3. Enhance GP awareness of diagnostic services.
  4. Create patient information leaflets on providing stool specimens.
  5. Improve communication and feedback between GPs and public health athorities, addressing notification processes and patient confidentiality concerns.
  6. Develop training modules for medical students and GPs, covering infectious diseases, food safety, and AGE management.