Prevalence of gastrointestinal and psychosomatic symptoms among Asian patients undergoing regular hemodialysis

Abstract

Gastrointestinal (GI) symptoms are reported to be common among patients with chronic disorders including end-stage renal disease (ESRD). This questionnaire study assessed the prevalence of GI symptoms among patients undergoing hemodialysis (HD) and to correlate with the presence of diabetes mellitus and psychosomatic symptoms in Asian patients with ESRD. A total of 123 patients (male 47.2%) participated in this study. GI symptoms (upper GI: anorexia, nausea, vomiting, odynophagia, dysphagia, early satiety, heartburn, dyspepsia and lower GI: abdominal bloating, non-epigastrium abdominal pain, bowel habit and bleeding per rectum) and psychosomatic symptoms (anxiety, backache, depression, headache and insomnia) in the previous 12 months were enquired and compared with age and gender matched controls (n = 197). The mean age of patients was 51.8 ± 12.9 years with mean duration of HD of 28 ± 38.2 months. Overall, 70.7% of ESRD patients had experienced any GI symptoms; upper GI, 65% and lower GI, 34.1%, significantly more than controls (P < 0.05). ESRD patients had more anorexia, nausea, vomiting, dyspepsia, irregular bowel habit and bleeding per rectum (all P < 0.05). Overlap of upper and lower GI symptoms was reported by 34.1%, significantly higher than control (14.2%, P < 0.05). ESRD patients also experienced significantly more anxiety, depressive symptoms and insomnia (all P < 0.05). Among the patients with ESRD, the presence of any psychosomatic symptoms correlated significantly with the presence of any upper or lower GI symptoms and overlapping of GI symptoms. Such correlations were not seen with diabetes mellitus. Gastrointestinal and psychosomatic symptoms are common among our Asian patients with ESRD undergoing regular HD. The presence of underlying psychosomatic symptoms but not diabetes mellitus correlated significantly with the presence of GI symptoms.