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OBJECTIVE To identify patients with upper gastrointestinal symptoms and explore their clinical management in the primary care setting. METHOD The study population consisted of all patients who attended 5 rural health centers in the areas of Central Macedonia and Crete in Greece on 10 consecutive days. In total 992 patients were evaluated for upper gastrointestinal symptoms using questionnaires validated for Greek use: IDGP concerning dyspepsia and RDQ for Gastroesophageal Reflux Disease (GERD). All patients with positive indications were referred for upper endoscopy. Those patients who refused upper endoscopy were further evaluated for Helicobacter pylori (HP) infection with the urea breath test (UBT). RESULTS Of the 992 participants, 160 (16.12%) were found positive for dyspepsia according to the IDGP, while in 156 (15.72%) there were also symptoms of GERD. Twenty patients were found positive for HP through endoscopy and 65 through UBT. An increased frequency of upper gastrointestinal symptoms was observed in these two rural areas of Greece. CONCLUSIONS The use of specific questionnaires appears to contribute to the early identification and better clinical management of patients with upper gastrointestinal symptoms in primary care. [ABSTRACT FROM AUTHOR]