Different Quality of Life Between GERD and Barrett's Esophagus (Am J Gastroenterol 2009;104:2695-2703)

Abstract

Lippmann et al.1 published a report entitled Quality of life in GERD and Barrett's esophagus is related to gender and manifestation of in the September issue of American Journal of Gastroenterology in 2009. Authors carried out a cross-sectional analysis of data from a case-control study of Barrett's esophagus (BE) and gastroesophageal reflux disease (GERD) patients to examine whether patients with BE have different health-related quality of life (HRQoL) than patients with erosive reflux disease (ERD) and non-erosive reflux disease (NERD), after controlling for patient's perception of GERD symptom severity. Participants completed questionnaires assessing generic HRQoL [medical outcomes study short form-36 (SF-36)], disease-specific HRQoL [gastrointestinal quality of life index (GIQLI)], a measure of psychological distress (the Revised Hopkins Symptom Checklist: SCL-90R), and a patient-centered assessment of the impact of disease severity [the GERD health-related quality of life measure (GERD HRQL)]. Patients with BE had the lowest symptom severity compared with those suffering from NERD or ERD. Those with BE also had better disease-specific quality of life compared with NERD or ERD patients. After adjusting for potential confounding variables including symptom severity and gender, BE patients continued to demonstrate better disease-specific HRQoL (GIQLI) than NERD or ERD patients, as well as better generic HRQoL (SF-36) than NERD or ERD patients. There were no significant differences between groups in psychological distress, as demonstrated by the SCL-90R global severity index, although BE patients scored lower on the somatization domain compared with NERD and ERD patients. When stratified by gender, females with NERD and BE had worse disease-specific HRQoL (GIQLI) than males. This finding suggests that patients with BE have better generic and disease-specific HRQoL when compared with patients suffering from NERD and ERD. In addition, female was associated with worsened HRQoL regardless of GERD disease manifestation.