Impact Of Eosinophilic Esophagitis Research Articles

The impact of eosinophilic esophagitis on the quality of life in children

Eosinophilic esophagitis, although relatively recently in­tro­duced as a concept in specialty literature and among di­ges­tive diseases, presents an increasingly high incidence in the pediatric population. It represents a complex pathology, a chronic immune-mediated inflammatory disorder, with va­rious phenotypes and symptomatology, depending on age. This pathology may cause severe complications, such as esophageal strictures, which are associated with an increased risk of impaction of food in the esophagus. The quality of life of these children is often low and, un­for­tu­na­tely, the consequences of this disease will persist even in the adult life.

Disease duration determines health‐related quality of life in adult eosinophilic esophagitis patients

Eosinophilic esophagitis (EoE) is a chronic inflammatory disease of the esophagus characterized by relapsing symptoms of dysphagia. The quality of life (QoL) of EoE patients is impaired, but risk factors for impaired QoL have not been identified. The chronic nature of the disease, requiring multiple endoscopies and long-term treatments, and its social implications may be important factors underlying the impaired QoL of EoE patients. We aimed to determine which clinical factors influence the QoL in EoE patients. In this cross-sectional study, we consecutively included 74 adult patients (age 40.3±13.6years, 23% female) diagnosed with EoE according to current guidelines. Patients filled out the SF-36 health-related QoL questionnaire and a questionnaire for assessing clinical data. Patients' SF-36 scores were compared with norm scores from a reference population of 1742 randomly selected subjects. In EoE patients, vitality (62.1±22.3 vs 68.6±19.3, p=0.015) and general health (64.4± 24.2 vs 70.9±20.6, p=0.024) domains of QoL were decreased, the latter primarily in the 18-25year age group (50.1±30.5 vs 77.9±17.2, p=0.006). Disease duration is a risk factor for a low mental component summary score, as identified by univariate regression analysis (OR 1.064 (CI: 1.003-1.128), p=0.038). The QoL is particularly impaired in young adult EoE patients. Disease duration determines the mental QoL. This study offers additional insight into the impact of EoE on patients' lives and emphasizes the importance of early diagnosing and adequately treating EoE.

Su1136 Fibrostenotic Complications in Adults With Eosinophilic Esophagitis

Introduction: Health RelatedQuality of Life (QOL) is an important outcome in the assessment of the affects of disease on patients. Global QOL instruments are often too broad to accurately evaluate specific disease states. Eosinophilic esophagitis (EoE) is an increasingly recognized disease associated with significant morbidity. The EoE-QOL-A is a reliable and valid, 5scale 37-item instrument to evaluate QOL in adults with EoE. We sought to confirm its construct validity and acceptability via qualitative cognitive interviews and item refinement. Methods: EoE patients aged 19-69 were recruited via both a university-based outpatient GI clinic and laboratory. EoE was defined based on recent consensus recommendation guidelines. Patients underwent structured cognitive interviews about the EoE-QOL-A to assess clarity, understandability, length, rhetoric, and potential variability in interpretation for each question. Patient responses were reviewed by 3 gastroenterologists, 2 clinical psychologists, and a medical student to appropriately refine the original survey items and format. Results: 10 patients were interviewed; Mean±SD age was 33.8±15.0 yrs; 90% of patients were Caucasian; 90% college-educated. Patients had EoE for 12.9±12.5 yrs. In the past 7 days, patients rated their EoE symptom severity as a 2.6±.90 (5 point global severity score), and rated overall impact of EoE on their daily life at 3.5±.76 (5 point scale). 60% were currently being treated with steroids and/or dietary therapies; 50% used oral/inhaled steroids, 20% used elimination diet therapies. Based on interview data, 7 questions were deleted because of nearly unanimous agreement in lack of clarity, relevance and/or repetitiveness with other questions within the survey. 8 questions were re-phrased to alleviate leading rhetoric and/or ambiguity in wording that led to extensive variability in interpretation. 6 questions were entirely separated for only patients on elimination diet therapies as the 80% of patients not on such therapies found these questions to be irrelevant or not applicable. The final measure was reduced from 37 to 24 items with a 6-question addendum for those on the elimination diet therapies. Conclusions: The final stage of patient reported outcome (PRO) validation of the EoE-QOL-A by means of cognitive interviews of adults with EoE led to a refined, 30-item scale. The measure meets the recommended guidelines for PRO development, allowing for assessment of the impact of EoE on adult patients across multiple domains in both research and clinical settings.

Qualitative Assessment of Patient-reported Outcomes in Adults With Eosinophilic Esophagitis

This study aims to qualitatively describe experiences of adult patients diagnosed with eosinophilic esophagitis (EoE). Specifically, we aim to identify disease-specific concerns related to patient-reported outcomes in this population to inform clinical care and assessment. EoE is a chronic inflammatory disease of the esophagus and is increasingly recognized as a cause of dysphagia in adults. On the basis of its symptoms, limited and restrictive treatment options and potential for social and psychological impact, it is logical to expect that the health related quality of life of EoE patients would be an important outcome marker for assessment. Twenty-four EoE patients participated in semistructured interviews about their illness experiences. Participants also provided demographic and clinical data, and completed the Medical Outcome Study Short Form 12 to assess mental and physical function. Six themes emerged from qualitative analyses which centered around 3 main points: concerns about the illness itself, concerns about swallowing difficulty, and concerns about the impact of EoE on social interactions. Patients were generally open to disclosing their illness status and reported relief at receipt of the EoE diagnosis. EoE patients did not differ from healthy norms for physical well-being, and were similar to comparable illness groups for mental functioning. Our study demonstrated that EoE has substantial impact on several psychosocial domains that are not adequately addressed by focused assessment of physical complaints of dysphagia. The results support the importance of development of disease-specific instruments pertaining to quality of life in EoE patients.

Impact of Eosinophilic Esophagitis (EoE) on Quality of Life (qol) for Youth and Their Families

Impact of Eosinophilic Esophagitis (EoE) on Quality of Life (qol) for Youth and Their Families

The Impact of Eosinophilic Esophagitis on the Daily Activities of Children and Families

The Impact of Eosinophilic Esophagitis on the Daily Activities of Children and Families