Quality of life in relation to symptoms in patients with gastro‐oesophageal reflux disease — an analysis based on the ProGERD initiative

Abstract

SUMMARYAims: To determine the impact of gastro-oesophageal reflux disease (GERD) on the quality of life, to assess changes in the quality of life during treatment with esomeprazole and to define factors that can predict these changes. Methods: Patients with GERD (n ¼ 6215) were included in a prospective cohort study (ProGERD). All patients underwent endoscopy and received esomeprazole. At baseline and after 2 weeks of treatment, symptoms and quality of life were assessed. Factors that influenced changes in the quality of life were determined by multiple regression analyses. Results: At baseline, the quality of life in GERD patients was lower than that in the general population, and was similar to that in patients after acute coronary events. No differences in symptoms or quality of life were observed between the subgroups of patients with nonerosive GERD, erosive GERD and Barrett's oesophagus.After treatment with esomeprazole, the symptoms and quality of life were improved in all subscales within 2 weeks (P < 0.001). The mean score of the diseasespecific quality of life instrument (Quality of Life in Reflux and Dyspepsia Patients) increased from 4.6 to 6.2 points, representing a highly relevant clinical improvement. The generic quality of life (SF-36) reached levels similar to those in the general population, but, again, no difference was found between the three different subgroups of GERD patients. The main factors associated with an improvement in the quality of life after treatment were symptom relief, severe erosive reflux disease, absence of extra-oesophageal disorders, avoidance of non-steroidal anti-inflammatory drug intake and positive Helicobacter pylori status. Conclusions: GERD causes a significant impairment in the quality of life that can be attenuated or normalized within a time period as short as 2 weeks by treatment with esomeprazole. These findings were similar across the whole GERD patient spectrum.

Recurrence and Its Impact on the Health-related Quality of Life in Patients with Gastroesophageal Reflux Disease: A Prospective Follow-up Analysis

“…12,14,15 Although HRQoL improves with treatment, persistent symptoms after PPI therapy are associated with a reduced HRQoL. 14,16,17 However it is unclear how the recurrence of GERD symptoms impacts patients' HRQoL. Furthermore, there have been no reports regarding the difference in the impact of relapsed GERD symptoms on HRQoL between patients with erosive reflux disease (ERD) and non-erosive reflux disease (NERD).…”

Hiatal Hernia, Lower Esophageal Sphincter Incompetence, and Effectiveness of Nissen Fundoplication in the Spectrum of Gastroesophageal Reflux Disease

“…5 As a group, patients with NERD have symptom and quality of life scores similar to patients with erosive reflux disease (ERD). 4,6 Patients can progress from NERD to ERD, even on proton-pump inhibitor (PPI) therapy, but progression from ERD to BE is uncommon and from NERD to BE is very uncommon. [7][8][9] Labenz et al reported on the progression of GERD (ProGERD) study of 3,894 patients with GERD who underwent baseline endoscopy and repeat endoscopy at 2 years.…”

Quality of life in patients with gastroesophageal reflux disease following pharmacotherapeutic, endoscopic, and surgical treatment

“…Therapy with proton pump inhibitors (PPI) was reflected by an increase in psychological and physical status measured with SF-36. Among others, the improvement was more evident in patients with more severe oesophagi-tis (C and D according to the Los Angeles scale) as well as in those with more severe manifestations [13]. The level of quality of life in reflux disease was comparable to that observed in mild-degree heart failure [18].…”

“…Although GERD is a mild condition, HRQOL in GERD patients is significantly lower than in the general population [12][13][14]. Revicki et al [12] observed that GERD impairs HRQOL in all areas of health analysed with the SF-36 questionnaire.…”