INFLUENCE OF ACCOMPANYING GASTRODUODENAL PATHOLOGY ON CLINICAL SYMPTOMS AND QUALITY OF LIFE OF PATIENTS WITH CHRONIC PANCREATITIS
DOI:
https://doi.org/10.11603/1811-2471.2023.v.i2.13853Keywords:
chronic pancreatitis, H. Pylori-associated chronic gastritis, gastroduodenal changes, quality of life, SF-36 questionnaire, GSRS gastroenterological patient questionnaireAbstract
SUMMARY. In spite of the considerable advance in the research of pancreatic pathology, clinical symptoms and syndromes, along with the life quality evaluation with the use of SF-36 and GSRS questionnaires of patients with chronic pancreatitis combined with comorbid pathology of gastroduodenal zone (GDZ) organs continues to be studied and substantiated insufficiently.
The aim – to study the clinical symptoms and assess life quality using the SF-36 and GSRS questionnaires in the comorbidity of chronic pancreatitis with H. Pylori-associated chronic gastritis.
Material and Methods. 30 outpatients with CP and 117 with CP in comorbidity with chronic gastritis (CG) associated with H. Pylori were examined. A combined assessment of clinical manifestations (symptoms/syndromes) of patients with CP and CP with H. Pylori-associated chronic gastritis was conducted. For the reliable assessment of life quality, groups of patients were compared: the control group, patients with CP and patients with comorbidity. The physical and psychological components were evaluated using the SF-36 questionnaire. Indicators of the life quality components of patients of both groups were also studied according to the scales of the GSRS questionnaire.
Results. The clinical symptoms in the comorbidity of CP with accompanying gastroduodenal disorders had specific features compared to those in isolated CP: a smaller number of patients had a pain syndrome (93.3 % vs. 100.0 %); dyspepsia syndrome was found in all the patients with comorbid pathology (100.0 % vs. 86.7 %), a significantly larger number of such patients had nausea (63.3 % vs. 26.5 %), a feeling of heaviness (26.7 % vs. 18,8 %), diarrhea (33.3 % vs. 17.9 %), alternating diarrhea and constipation (26.7 % vs. 23.1 %), enteropancreatic and asthenoneurotic syndromes were detected with a slight advantage in patients with comorbidity – 72.6 % against 66.7 %, and 90.0 % against 83.8 %.
It was found that the average total index of the physical component of patients with CP with comorbidity compared to that in the group of isolated CP according to the SF-36 questionnaire was found to be significantly lower: the difference between the values of the average total index of the physical component of life quality of the patients from the comparison groups was 10.42 points (11.2 %).
Conclusion. It was established that the difference between the total indicators of the psychological component scales of the life quality according to the SF-36 questionnaire of the groups of patients with CP and patients with comorbidity is 9.71 (11.5 %), which proved that the psychological state of patients with CP with concomitant gastroduodenal changes was significantly worse.
The total index of the GRSR scales in the group of patients with CP+GDC (gastroduodenal changes) is significantly higher than of the group with isolated CP – by 1.52 times, and this proved a significantly lower quality of life according to the state of gastroenterological syndromes of the GSRS questionnaire (р≤0.05).
References
Zhu, X, Zhu, C, Zhao, Y, Liu, X, Sa, R, & Wang, Y. (2023). Prevalence of Helicobacter pylori Virulence Genes and Their Association with Chronic Gastritis in Beijing. China. Curr. Microbiol., 80(1). DOI: 10.1007/s00284-022-03135-6.
Hooi, J.K.Y., Lai, W.Y., Ng ,W.K., Suen, M.M.Y., Underwood, F.E., & Tanyingoh, D. (2017). Global Prevalence of Helicobacter pylori Infection: Systematic Review and Meta-Analysis. Gastroenterology, 153(2), 420-429. DOI: 10.1053/j.gastro.2017.04.022.
Graham, D.Y. (2014). History of Helicobacter pylori, duodenal ulcer, gastric ulcer and gastric cancer. World J. Gastroenterol., 20(18), 5191-5204. DOI: 10.3748/wjg.v20.i18.5191.
Nagy, P., Johansson, S., & Molloy-Bland, M. (2016). Systematic review of time trends in the prevalence of Helicobacter pylori infection in China and the USA. Gut. Pathogens, 8(1). DOI: 10.1186/s13099-016-0091-7.
Conwell, D.L., Lee, L.S., Yadav, D., Longnecker, D.S., Miller, F.H., & Mortele, K.J. (2014). American Pancreatic Association practice guidelines in chronic pancreatitis evidence-based report on diagnostic guidelines. Pancreas, 43(8), 1143-1162. DOI: 10.1097/MPA.0000000000000237.
Kalivarathan, J., Yadav, K., Bataller, W., Brigle, N.W., & Kanak, M.A. (2019). Etiopathogenesis and pathophysiology of chronic pancreatitis. Transplantation, Bioengineering, and Regeneration of the Endocrine Pancreas, 2, 5-32. DOI: 10.1016/B978-0-12-814831-0.00001-4.
Sankaran, S.J., Xiao, A.Y., Wu, L.M., Windsor, J.A., Forsmark, C.E., & Petrov, M.S. (2015). Frequency of Progression from Acute to Chronic Pancreatitis and Risk Factors: A Meta-analysis. Gastroenterology, 149(6), 1490-1500. DOI: 10.1053/j.gastro.2015.07.066.
DeSouza, S.V., Singh, R.G,. Yoon, H.D., Murphy, R., Plank, L.D., & Petrov, M.S. (2018). Pancreas volume in health and disease: a systematic review and meta-analysis. Expert. Rev. Gastroenterol. Hepatol., 12(8), 757-766. DOI: 10.1080/ 17474124.2018.1496015.
Peery, A.F., Crockett, S.D., Murphy, C.C., Lund, J.L., Dellon, E.S., & Williams, J.L. (2019). Burden and Cost of Gastrointestinal, Liver, and Pancreatic Diseases in the United States: Update 2018. Gastroenterology, 156(1), 254-272. DOI: 10.1053/j.gastro.2018.08.063.
Gardner, T.B., Adler, D.G., Forsmark, C.E., Sauer, B.G., Taylor, J.R., & Whitcomb, D.C. (2020). ACG Clinical Guideline: Chronic Pancreatitis. Am. J. Gastroenterol., 115(3), 322-339. DOI: 10.14309/ajg.0000000000000535.
Petrov, M.S., & Yadav D. (2019). Global epidemiology and holistic prevention of pancreatitis. Nat. Rev. Gastroenterol. Hepatol., 16(3), 175-184. DOI: 10.1038/s41575-018-0087-5.
Olesen, S.S., Juel, J., Nielsen, A.K., Frøkjær, J.B., Wilder-Smith, O.H.G., & Drewes, A.M. (2014). Pain severity reduces life quality in chronic pancreatitis: Implications for design of future outcome trials. Pancreatology, 14(6), 497-502. DOI: 10.1016/j.pan.2014.09.009.
Du, L.J. (2016). Helicobacter pylori eradication therapy for functional dyspepsia: Systematic review and meta-analysis. World J. Gastroenterol., 22(12), 3486-3495. DOI: 10.3748/wjg.v22.i12.3486.
Pogorzelska, J., Łapińska, M., Kalinowska, A., Łapiński, T.W., & Flisiak, R. (2017). Helicobacter pylori infection among patients with liver cirrhosis. Eur. J. Gastroenterol. Hepatol., 29(10), 1161-1165. DOI: 10.1097/MEG.0000000000000928.
Amieva, M., & Peek, R.M. (2016). Pathobiology of Helicobacter pylori–Induced Gastric Cancer. Gastroenterology, 150(1), 64-78. DOI: 10.1053/j.gastro.2015.09.004.
Olesen, S.S., Nøjgaard, C., & Poulsen, J.L. (2019). Chronic Pancreatitis Is Characterized by Distinct Complication Clusters That Associate With Etiological Risk Factors. Am. J. Gastroenterol., 114(4), 656-664. DOI: 10.14309/ajg.0000000000000147.
Bai, X., Zhu, M., He, Y., Wang, T., Tian, D., & Shu, J. (2022). The impacts of probiotics in eradication therapy of Helicobacter pylori. Arch. Microbiol., 204(12). DOI: 10.1007/s00203-022-03314-w.
Wu, X., Xu, X., Xiang, Y., Fan, D., An, Q., & Yue, G. (2022). Exosome-mediated effects and applications in inflammatory diseases of the digestive system. Eur. J. Med. Res., 27(1). DOI: 10.1186/s40001-022-00792-y.
Palmer, B., & Petrik, M. (2022). Psychological Evaluation and Management of Chronic Pancreatitis. Gastroenterol. Clin. North Am., 51(4), 799-813. DOI: 10.1016/j.gtc.2022.07.006.
Koch, R.M., Tchernodrinski, S., & Principe, D.R. (2022). Case report: Rapid onset, ischemic-type gastritis after initiating oral iron supplementation. Front. Med., 9. DOI: 10.3389/fmed.2022.1010897.
Cañamares-Orbís, P., García-Rayado, G., & Alfaro-Almajano, E. (2022). Nutritional Support in Pancreatic Diseases. Nutrients, 14(21). DOI: 10.3390/nu14214570.
Greer, J.B., Greer, P., Sandhu, B.S,. Alkaade, S., Wilcox, C.M., & Anderson, M.A. (2019). Nutrition and Inflammatory Biomarkers in Chronic Pancreatitis Patients. Nutr. Clin. Prac., 34(3), 387-399. DOI: 10.1002/ncp.10186.
Ahmed, A., Anand, A.N., Shah, I., Yakah, W., Freedman, S.D., & Thomas, R. (2022). Prospective evaluation of sleep disturbances in chronic pancreatitis and its impact on quality of life: a pilot study. Sleep Breathing, 26(4), 1683-1691. DOI: 10.1007/s11325-021-02541-7.
Phillips, A.E., Faghih, M., Drewes, A.M., Singh, V.K., Yadav, D., & Olesen, S.S. (2020). Psychiatric Comorbidity in Patients with Chronic Pancreatitis Associates with Pain and Reduced Quality of Life. Am. J. Gastroenterol., 115(12), 2077-2085. DOI: 10.14309/ajg.0000000000000782.
Machicado, J.D., Amann, S.T., Anderson, M.A., Abberbock, J., Sherman, S., & Conwell, D.L. (2017). Quality of Life in Chronic Pancreatitis is Determined by Constant Pain, Disability/Unemployment, Current Smoking, and Associated Co-Morbidities. Am. J. Gastroenterol., 112(4), 633-642. DOI: 10.1038/ajg.2017.42.
