General Well-being and Coping Strategies in Adult Eosinophilic Esophagitis Patients

Abstract

Background/AimsGrowing evidence suggests a negative effect of eosinophilic esophagitis (EoE) on patients' general health-related quality of life (HRQOL). However, the relevance and use of coping strategies and its relation to (disease specific) HRQOL as well as its determinants have not been studied well. MethodsAdult EoE patients were invited to complete standardized measures on general HRQOL ) and coping strategies (Utrechtse Coping Lijst [UCL]). Scores were compared to general population norms. The disease specific Adult Eosinophilic Esophagitis Quality of Life (EoE-QOL-A) measure was used to assess EoE-HRQOL. Socio-demographic-and clinical factors were also evaluated. ResultsIn total, 147 adult EoE patients (61% males), age 43 (interquartile range, 29-52) years were analyzed. Mental health-scores (SF-36) were significantly lower in EoE patients, whereas physical health-scores (SF-36) were similar in EoE patients (vs the general population; P = 0.010 and P = 0.240), respectively. The subdomain "disease anxiety" (EoE-QOL-A) was mostly affected, determinants were; female gender, younger age, severe clinical disease activity, higher number of food bolus extraction, and more recent EoE-diagnosis. Less effective coping styles (ie, passive/palliative reaction) were associated with a significant impact on each individual EoE-HRQOLsubdomain as well as lower scores of the Mental Health Component Scale in male EoE patients. Passive reaction in female EoEpatients correlated with impairment of the EoE-HRQOL-domains "emotional impact" and "disease anxiety." Active problem solving was significantly related to better perception of mental HRQOL (SF-36) in both males and females. ConclusionsEoE has a significant negative impact on mental HRQOL, with less effective coping strategies--specifically in males, being a relevant determinant. Thus, a pro-active approach towards coping mechanisms is needed in order to enhance HRQOL and manage patients' burden of EoE.

Fibrous Remodeling in Eosinophilic Esophagitis: Clinical Facts and Pathophysiological Uncertainties

“…This has been documented by manometry records: a variety of ineffective peristalsis patterns have been described in patients with EoE (which reverse after short-term anti-inflammatory treatment), together with dysphagia improvement [75][76][77][78]. Most patients usually develop coping strategies by adapting eating behaviors, or the use of dietary restrictions to manage symptoms and avoid food impactions in particular [79]. Esophageal narrowing and stricture formation under a certain lumen caliber will be a major determinant for food impaction.…”

Swallowed topical corticosteroids for eosinophilic esophagitis: Utilization and real‐world efficacy from the EoE CONNECT registry

“…Symptoms present as impaired function of the esophagus, histologically characterized by dense infiltration by eosinophils in this organ. 1 These symptoms have a significantly negative impact on patients' and their families' mental health‐related quality of life, 2 , 3 and persistent inflammation may deteriorate the esophageal function, causing dysmotility and strictures due to fibrous remodeling, 4 , 5 thus indicating a need for treatment.…”