Clinical assessment and health-related quality of life in patients with non-cardiac chest pain.

INTRODUCTION: Non-cardiac chest pain (NCCP) is mainly related to oesophageal disease, and in spite of being a common condition in Mexico, information regarding it is scarce. AIM: To assess the clinical characteristics and health-related quality of life of patients with NCCP of presumed oesophageal origin. MATERIAL AND METHODS: Patients with NCCP of presumed oesophageal origin with no previous treatment were included in the study. Associated symptoms were assessed and upper gastrointestinal endoscopy and 24-hour oesophageal pH monitoring were performed to diagnose gastroesophageal reflux disease, while oesophageal manometry was used to determine oesophageal motility disorders. The SF-36 Health-Related Quality of Life (HR-QoL) questionnaire was completed and its results compared to a control group without oesophageal symptoms. RESULTS: The study included 33 patients, of which 61% were women, and the mean age was 46.1 (±11.6) years. Causes of NCCP were gastroesophageal reflux disease in 48%, achalasia in 34%, and functional chest pain in 18%. The average progression time for chest pain was 24 (2-240) months, with ≤ 3 events/week in 52% of the patients. The most frequent accompanying symptoms were: regurgitation (81%), dysphagia (72%) and heartburn (66%). Patients with NCCP show deterioration in HR-QoL compared to the control group (P=.01), regardless of chest pain aetiology. The most affected areas were general perception of health, emotional issues, and mental health sub-scale (P>0.05). CONCLUSIONS: In our population, patients with NCCP show deterioration in HR-QoL regardless of the aetiology, frequency, and accompanying symptoms.

[Impact of the anxiety characteristics and depression on clinical aspects and quality of life in patients with irritable bowel syndrome]. / Impacto de los rasgos de ansiedad y depresión sobre aspectos clínicos y calidad de vida en pacientes con síndrome de intestino irritable.

BACKGROUND: Anxiety and depression have been related with seeking medical care by IBS patients, however their impact over the clinical characteristics and health related quality of life (HRQOL) of the patients, is unknown. AIMS: To evaluate the impact of these traits over the symptoms, number of consultations and HRQOL in IBS. METHODS: Consecutive moderate to severe IBS-Rome I patients that consulted a reference center in Mexico City, answered the HAD, a Bowel Symptom Questionnaire and the SF-36. Patients were compared according to the presence or absence of anxiety or depression. RESULTS: Anxiety was found in 70%, depression in 46% and both traits among 40%. The majority of those with depression were single compared to a married majority in those without this trait (p = 0.03). Those with anxiety (p = 0.03) and depression (p = 0.006) reported more number of days with abdominal pain/ discomfort and both traits (p = 0.000) were associated with a higher frequency of fullness, distention, abdominal pain, incomplete evacuation, abnormal bowel movements and lower HRQOL. Patients with anxiety reported a more severe IBS and those with depression a higher frequency of diarrhea predominance (p = 0.047). CONCLUSIONS: Traits anxiety and depression negatively impacted over the number of days, symptom frequency and HRQOL of patients with moderate to severe IBS. More studies are needed to determine if these psychological symptoms are causing these outcomes or if the gastrointestinal symptoms and poor HRQOL are triggering anxiety and depression in IBS.