Gastrovigilance: A Close Watch on Gastrointestinal and Hepatic Disorders- An Indian Perspective

Abstract

Gastrointestinal and hepatic disorders account for about 25% of consultations among general practitioners in India. Errors in clinical judgement and hesitancy in recommending necessary tests owing to lack of health insurance could result in delayed diagnosis and increased patient morbidity and mortality. Clinicians should thus be well equipped with effective strategies for skilful diagnosis and in a position to weigh the benefit-risk-ratio of recommending pertinent and disregarding less useful diagnostic tests. 'Gastrovigilance' includes disease-specific training for recognising risk factors, algorithms and referral pathways. This narrative review focuses on the common challenges or errors in managing these conditions in Indian clinical practice and their proposed solutions. Literature searches were performed using PubMed/MEDLINE and Google Scholar following the shortlisted gastrointestinal conditions. Based on the published literature and expertise of the senior gastroenterologists, improving disease-specific knowledge can enhance rates of correct diagnosis. Improved screening and patient education can reduce the risk of presentation at advanced stages and consequently improve prognosis. Another significant contributory factor is the patient-physician interaction which affects every stage of the disease management and methods to improve it, therefore vital in improving gastrointestinal and hepatic disease conditions. The most important means of improving gastrovigilance is optimising knowledge access in primary care. This shall improve diagnostic accuracy and reduce the burden of misdiagnosis. In the current narrative review, we have tried to elucidate the concept of gastrovigilance for gastrointestinal and hepatic conditions and substantiate it with published evidence.