Clinical, emotional and social factors associated with quality of life in chronic pancreatitis.

BACKGROUND: In chronic pancreatitis (CP), a debilitating, progressive and incurable disease, patients' wellbeing is considerably impaired, but the different factors affecting quality of life (QoL), have not been identified yet. METHODS: 69 patients with CP were evaluated (M/F 55/14; mean age 46.6 +/- 10.05 years). Different degrees of pancreatic damage were defined using the Cambridge classification; pain intensity and frequency were assessed using pain index. QoL was measured using EORTC QLQ-C30 and the PAN26 questionnaire. Although developed for pancreatic cancer, the C30/PAN26 has been validated for chronic pancreatitis. RESULTS: Digestive symptoms, financial difficulties, fear of future health and general pain scales showed considerable effects of CP on QoL. We observed significant negative correlation between mean QoL scores and pain index in almost all domains (p < 0.001, p < 0.05). Pain intensity affects QoL scales more often than pain frequency. BMI correlated positively with QoL in global health status, altered bowel habits, body image and satisfaction with health care domains (p < 0.01, p < 0.05). CONCLUSION: Pain index, BMI, Cambridge classification and disease duration are the most important factors adversely affecting QoL in CP. Measurement of QoL is essential in the disease management and improves the knowledge of psychosocial functioning of these patients. and IAP.

The comparison of Health-Related Quality of Life (HRQL) in patients with GERD, peptic ulcer disease and ulcerative colitis.

PURPOSE: The aim of the study was to compare HRQL in patients with three common gastroenterological chronic conditions: gastroesophageal reflux disease (GERD), peptic ulcer disease (PUD) and ulcerative colitis (UC), as well as to assess the correlation between HRQL scores and the disease activity in patients with ulcerative colitis. MATERIAL AND METHODS: The study group comprised of 45 patients with GERD, 35--with PUD and 30--with UC. Among patients with UC, 7 were in remission, 13--in mild active and 10--with severe phase of the disease, according to Rachmilewitz. HRQL was assessed using 8 domains of Polish version of 36-Item Short Form Survey (SF-36). RESULTS: The highest mean HRQL scores in all groups were obtained in physical and social functioning SF-36 domains. Among patients with GERD and PUD the worst HRQL results were noted in bodily pain subscale; in patients with UC--in general health perception subscale. UC patients with remission showed significantly higher HRQL scores compared with those with mild active and severe phase of the disease; especially in social functioning, mental health and vitality (p < 0.001). Patients with severe UC clinical course had mean HRQL scores statistically lower than those with mild active disease only in vitality and social functioning domains. Mean SF-36 bodily pain parameters were significantly lower in GERD and PUD compared with UC. CONCLUSIONS: All the evaluated diseases have a significant negative impact on patients' HRQL parameters, which needs to be considered in those diseases management. The severity of UC clinical course contributes to impaired HRQL.