Abstract
BackgroundGastroesophageal reflux disease (GERD) has become a major health problem globally, affecting patients’ health-related quality of life (HRQOL). Barrett’s esophagus (BE) is a precancerous lesion associated with GERD. BE patients might not only suffer from HRQOL losses by GERD but also face psychological distress due to the increased risk of developing cancer. However, the majority of patients in Asia have shorter BE segment which is different from the West. This study aimed to determine whether the HRQOL in BE patients were worse than in healthy referents in Taiwan.MethodsPatients who received referral esophagogastroduodenoscopy for various symptoms were evaluated for the existence of BE. Lesions were judged as endoscopically suspected esophageal metaplasia (ESEM) if they showed morphological resemblances to BE by endoscopy. The diagnosis of BE was confirmed by histology with intestinal metaplasia or gastric metaplasia based on the Montreal definition. The World Health Organization Quality of Life (WHOQOL-BREF) was administered to BE patients before treatment. For each BE patient, we selected 2 age-, sex-, educational background and municipality-matched healthy referents, sampled by simple randomization method from a national survey in Taiwan. Multiple linear regression models were constructed to control the potential confounders.ResultsA total of 84 patients diagnosed with BE were enrolled as BE group and then compared with 168 healthy referents. The BE group had significantly lower WHOQOL-BREF scores than those of healthy referents in the physical domain (P < 0.05) but higher scores in the environment domain (P < 0.05). In the physical domain, the BE group had significantly lower scores in various facets, including pain, discomfort, sleep and rest and dependence on medications or treatments. There was no significant difference in social and psychological domains between the BE group and healthy referents.ConclusionsBE patients suffer from poor sleep and rest and high dependence on medications, which significantly reduce their quality of life. Individual facets of each domain warrants a better clinical healthcare to improve quality of life of BE patients.
Highlights
Gastroesophageal reflux disease (GERD) has become a major health problem globally, affecting patients’ health-related quality of life (HRQOL)
Considering that most Asian patients have shorter Barrett’s esophagus (BE) segment compared to patients in Western countries, this study aimed to determine whether HRQOL of BE patients were worse than healthy referents in the ethnic Chinese population in Taiwan, adjusted for potential confounding factors
Lesions were judged as endoscopically suspected esophageal metaplasia (ESEM) if they showed morphological resemblances to BE by endoscopy [32]
Summary
Gastroesophageal reflux disease (GERD) has become a major health problem globally, affecting patients’ health-related quality of life (HRQOL). Barrett’s esophagus (BE) is a precancerous lesion associated with GERD. BE patients might suffer from HRQOL losses by GERD and face psychological distress due to the increased risk of developing cancer. Gastroesophageal reflux disease (GERD) has become a major health problem globally [1,2,3,4]. Patients with GERD usually suffer from various symptoms, including heart burn, acid regurgitation, epigastralgia, non-cardiac chest pain, chronic cough, asthma and hoarseness. Patients with GERD may experience losses on their health-related quality of life (HRQOL) compared with the healthy population [5,6,7]. The reported prevalence of BE in Western countries varied from 6.3 to 13.6% in patients with GERD [5, 10,11,12]
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