Abstract
Background
Eosinophilic gastritis (EG) and eosinophilic gastroenteritis (EGE) are chronic immune-mediated conditions of the digestive tract, which affect the stomach only, or the stomach and small intestines, respectively. Though these disorders are uncommon, they are being increasingly recognized and diagnosed. While health-related quality of life (HRQOL) has been evaluated in other eosinophilic gastrointestinal diseases, this study is the first to describe HRQOL impacts unique to EG/EGE.
Aims
This study aims to qualitatively describe experiences of adults diagnosed with EG and EGE. We aim to identify impacts on HRQOL in this population in order to inform clinical care and assessment.
Methods
Seven patients diagnosed with EG or EGE participated in semi-structured interviews assessing common domains of HRQOL.
Results
Four distinct themes emerged from qualitative analyses, which represent impacts to HRQOL: the psychological impact of the diagnosis, impact on social relationships, financial impact, and impact on the body. These generally improved over time and with effective treatment.
Conclusions
This study demonstrated that patients with EG/EGE experience impacts to HRQOL, some of which differ from HRQOL of other eosinophilic gastrointestinal diseases. These results support the development of a disease-specific measure, or adaptation of an existing measure, to assess HRQOL in EG/EGE.
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References
Samiullah M, Bhurgri H, Sohail U. Eosinophilic disorders of the gastrointestinal tract. Prim Care. 2016;43:495–504.
Talley NJ, Shorter RG, Phillips SF, Zinsmeister AR. Eosinophilic gastroenteritis: a clinicopathological study of patients with disease of the mucosa, muscle layer, and subserosal tissues. Gut. 1990;31:54–58.
Gonsalves N, Furuta GT, Atkins D. Eosinophilic gastrointestinal disorders affect more than just the esophagus. J. Pediatr. Gastroenterol. Nutr. 2016;62:1–2.
Wilson IB, Cleary PD. Linking clinical variables with health-related quality of life: a conceptual model of patient outcomes. JAMA. 1995;273:59–65.
Meyer R, Godwin H, Dziubak R, et al. The impact on quality of life on families of children on an elimination diet for non-immunoglobulin E mediated gastrointestinal food allergies. World Allergy Organ. J. 2017;10:8.
Klinnert MD. Psychological impact of eosinophilic esophagitis on children and families. Immunol. Allergy Clin. N. Am. 2009;29:99–107.
Leffler DA, Acaster S, Gallop K, Dennis M, Kelly CP, Adelman DC. A novel patient-derived conceptual model of the impact of celiac disease in adults: implications for patient-reported outcome and health-related quality-of-life instrument development. Value Health. 2017;20:637–643.
Casellas F, Lopez-Vivancos J, Casado A, Malagelada JR. Factors affecting health related quality of life of patients with inflammatory bowel disease. Qual. Life Res. 2002;11:775–781.
Larsson H, Bergman K, Finizia C, Johansson L, Bove M, Bergquist H. Dysphagia and health-related quality of life in patients with eosinophilic esophagitis: a long-term follow-up. Eur. Arch. Otorhinolaryngol. 2015;272:3833–3839.
Ware JE Jr, Sherbourne CD. The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Med. Care. 1992;30:473–483.
Patrick DL, Drossman DA, Frederick IO, DiCesare J, Puder KL. Quality of life in persons with irritable bowel syndrome: development and validation of a new measure. Dig. Dis. Sci. 1998;43:400–411.
Mukkada V, Falk GW, Eichinger CS, King D, Todorova L, Shaheen NJ. Health-related quality of life and costs associated with eosinophilic esophagitis: a systematic review. Clin. Gastroenterol. Hepatol. 2017. https://doi.org/10.1016/j.cgh.2017.06.036.
Casellas F, Rodrigo L, Lucendo AJ, et al. Benefit on health-related quality of life of adherence to gluten-free diet in adult patients with celiac disease. Rev. Esp. Enferm. Dig. 2015;107:196–201.
Mager D, Marcon M, Brill H, et al. Adherence to the gluten free diet and health related quality of life in an ethnically diverse pediatric population with Celiac Disease. J. Pediatr. Gastroenterol. Nutr. 2018. https://doi.org/10.1097/MPG.0000000000001873.
Devlen J, Beusterien K, Yen L, Ahmed A, Cheifetz AS, Moss AC. The burden of inflammatory bowel disease: a patient-reported qualitative analysis and development of a conceptual model. Inflamm. Bowel Dis. 2014;20:545–552.
Wilburn J, Twiss J, Kemp K, McKenna SP. A qualitative study of the impact of Crohn’s disease from a patient’s perspective. Frontline Gastroenterol. 2017;8:68–73.
Irvine EJ. Quality of life–rationale and methods for developing a disease-specific instrument for inflammatory bowel disease. Scand. J. Gastroenterol. Suppl. 1993;199:22–27.
Taft TH, Kern E, Keefer L, Burstein D, Hirano I. Qualitative assessment of patient-reported outcomes in adults with eosinophilic esophagitis. J. Clin. Gastroenterol. 2011;45:769–774.
Taft TH, Kern E, Kwiatek MA, Hirano I, Gonsalves N, Keefer L. The adult eosinophilic oesophagitis quality of life questionnaire: a new measure of health-related quality of life. Aliment. Pharmacol. Ther. 2011;34:790–798.
U.S. Department of Health and Human Services FDA Center for Drug Evaluation and Research, U.S. Department of Health and Human Services FDA Center for Biologics Evaluation and Research, U.S. Department of Health and Human Services FDA Center for Devices and Radiological Health. Guidance for Industry: Patient-Reported Outcome Measures: Use in Medical Product Development to Support Labeling Claims: Draft Guidance. Health Qual Life Outcomes. 2006; 4:79.
Moustakas C. Phenomenological Research Methods. Thousand Oaks, CA: Sage Publications; 1994.
Ritchie J, Lewis J. Qualitative Research Practice: A Guide for Social Science Students and Researchers. Thousand Oaks, CA: Sage Publications; 2003.
Corbin J, Strauss A. Grounded theory research: procedures, canons, and evaluative criteria. Qual. Sociol. 1990;13:3–21.
Hycner RH. Some guidelines for the phenomenological analysis of interview data. Hum. Stud. 1985;8:279–303.
Promotion OoDPaH. Health-related quality of life & well-being. 2017 [cited 2017].
Lebel S, Jakubovits G, Rosberger Z, et al. Waiting for a breast biopsy: psychosocial consequences and coping strategies. J. Psychosom. Res. 2003;55:437–443.
Sexton S, Loflin R 3rd. The relief of getting a diagnosis. Am. Fam. Physician. 2009;80:1223.
Taft TH, Keefer L, Artz C, Bratten J, Jones MP. Perceptions of illness stigma in patients with inflammatory bowel disease and irritable bowel syndrome. Qual. Life Res. 2011;20:1391.
Jacoby A. Stigma, epilepsy, and quality of life. Epilepsy Behav. 2002;3:10–20.
Gerteis J, Izrael D, Deitz D, et al. Multiple Chronic Conditions Chartbook. Rockville, MD: Agency for Healthcare Research and Quality; 2014.
Casati J, Toner BB, de Rooy EC, Drossman DA, Maunder RG. Concerns of patients with inflammatory bowel disease: a review of emerging themes. Dig. Dis. Sci. 2000;45:26–31.
Pihl Lesnovska K, Hollman Frisman G, Hjortswang H, Borjeson S. Critical situations in daily life as experienced by patients with inflammatory bowel disease. Gastroenterol. Nurs. 2016;39:195.
Mishel MH. Uncertainty in illness. Image J. Nurs. Scholarsh. 1988;20:225–232.
Vidal A, Gomez-Gil E, Sans M, et al. Health-related quality of life in inflammatory bowel disease patients: the role of psychopathology and personality. Inflamm. Bowel Dis. 2008;14:977–983.
Guthrie E, Jackson J, Shaffer J, Thompson D, Tomenson B, Creed F. Psychological disorder and severity of inflammatory bowel disease predict health-related quality of life in ulcerative colitis and Crohn’s disease. Am. J. Gastroenterol. 2002;97:1994–1999.
Guadagnoli L, Taft TH, Keefer L. Stigma perceptions in patients with eosinophilic gastrointestinal disorders. Dis. Esophagus. 2017;30:1–8.
Dorn SD, Hernandez L, Minaya MT, et al. The development and validation of a new coeliac disease quality of life survey (CD-QOL). Aliment. Pharmacol. Ther. 2010;31:666–675.
Braun V, Clarke V. Successful Qualitative Research: A Practical Guide for Beginners. London: Sage; 2013.
Mansoor E, Saleh MA, Cooper GS. Prevalence of eosinophilic gastroenteritis and colitis in a population-based study, from 2012 to 2017. Clin Gastroenterol Hepatol. 2017;15:1733–1741.
Funding
Ms. Craven and Ms. Guadagnoli are supported by the T32DK101363 Training Grant in GI Physiology and Psychology.
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Bedell, A., Taft, T., Craven, M.R. et al. Impact on Health-Related Quality of Life in Adults with Eosinophilic Gastritis and Gastroenteritis: A Qualitative Assessment. Dig Dis Sci 63, 1148–1157 (2018). https://doi.org/10.1007/s10620-018-4978-7
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DOI: https://doi.org/10.1007/s10620-018-4978-7