Decision Report 201501702

Summary

Miss C attended the practice on a number of occasions for acute stomach pain, and was treated with omeprazole (medication for an acid-related stomach disorder or ulcer). Miss C then visited a private GP, who suggested she try esomeprazole (another stomach medication). Miss C told the practice this gave her some relief from her symptoms, and they gave her a repeat prescription. The practice also referred Miss C to a gastroenterologist (a doctor specialising in the treatment of conditions affecting the liver, intestine and pancreas) when she requested this (about six weeks after she first reported symptoms). Miss C later arranged a private endoscopy overseas, which showed that she had probably had a stomach ulcer which had now healed.

Miss C complained that the practice failed to diagnose a stomach ulcer and delayed in referring her to gastroenterology. She was also unhappy that the practice did not prescribe esomeprazole until she had received this from a private GP, and she raised concerns that her ulcer could have been caused by the practice prescribing ibuprofen in the past.

After taking independent advice from a GP, we did not uphold Miss C's complaints. We found that the practice's treatment was reasonable, and in line with national guidance on dyspepsia (indigestion) at the time. The adviser explained that Miss C did not have any 'alarm features' to warrant referral to gastroenterology, and omeprazole was an appropriate medication to treat both ulcers and gastritis (inflammation of the stomach). The adviser said Miss C did not take this medication for a long enough period to know whether or not it was effective (before switching to esomeprazole). The adviser also considered that it was reasonable that the practice previously prescribed ibuprofen (while this can cause either ulcers or gastritis, this is rare in patients under 60).