Comparison of health related quality of life parameters of previously non treated erosive and non-erosive gastroesophageal reflux patients

Introduction: Demonstrating benefit on health related quality of life (HRQOL) has become critical for therapies directed at several disease states. In GERD, a series of studies suggest that treatment is not only effective in relief of symptoms but in their direct adverse impact on HRQOL.

Aims: To compare the HRQOL parameters of previously untreated, erosive (ERD) and non-erosive (NERD) patients, frequently suffering from moderate/severe gastroesophageal reflux symptoms, in a prospective, population based study.

Patients and methods: Fifty-eight previously untreated patients (who gave written informed consent) filled the validated, Hungarian version of SF-36 (general) and the QOLRAD (reflux disease specific) questionnaires. Then all patients underwent upper panendoscopy as indicated by typical moderate/severe reflux symptoms. Statistical analysis was performed using Mann Whitney non-parametric test of Graph Pad Prism3 program.

Results: The whole 58 GERD patients' general HRQOL feature (SF 36 scores) was worse than the average populations'. Comparing the two subgroups of 35 ERD and 23 NERD patients, we detected significantly worse quality of life parameters in the NERD group according to the QOLRAD dimensions. Strong significance was found in the emotional status (p=0.0007), the food/drink problems (p=0.0083) and vitality (p=0.0018), week significance in physical status (p=0.0313). No significant differences were found in sleeping disorders.

Conclusion: Despite of the similar history and symptomatology of the patients, surprisingly significantly worse HRQOL was detected in the NERD subgroup. It's known from a previous Hungarian study that that 29% of GERD patients reported depression and 50% were anxious. Since we detected the strongest difference in the emotional status and vitality it takes a great interest, weather these mental dimensions will show the same differences after the PPI therapy and/or non-responsive NERD patients might need some kind of antidepressant co-therapy to reach the symptom-free status.