This article has been cited by other articles in PMC. Abstract Objective To assess the outcome of laparoscopic Heller myotomy for achalasia using a specific quality of life QoL instrument for gastrointestinal disorders. Summary Background Data Current therapies for achalasia do not restore normal esophageal motility but aim at palliating dysphagia. However, many other symptoms may persist that cannot be assessed objectively by currently available symptom scores. Although generic QoL instruments have shown improvement in QoL after myotomy, disease-specific QoL instruments may be more responsive to change and therefore more reliable for comparing outcomes of therapeutic options for achalasia. Results Starting in January , 73 consecutive patients were operated on laparoscopically for various clinical stages of achalasia.
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All rights reserved. Abstract AIM: To investigate the common gastro-intestinal symptoms and quality of life in severely obese subjects. The quality of life was studied using a specific gastrointestinal quality of life index GIQLI questionnaire. Severely obese patients had decreased scores in the domains of general health, including physical A significantly decreased score was found in nine items, and there was an increased score in one out of the 19 items in the domain of symptoms of the GIQLI questionnaire.
The decreased score in the domain of symptoms was correlated with increasing glycosylated hemoglobin HbA1c levels. The development of gastrointestinal symptoms is correlated increasing HbA1c, suggesting that a poor control of hyperglycemia might be the etiology. Keywords: Severe obesity, Quality of life, Gastro-intestinal symptoms, Glycosylated hemoglobin Core tip: This study found that the severely obese patients had a significant impaired general quality of life, including social, emotional and physical domain.
This finding is similar to previous studies and supports the role of bariatric surgery in treating this group of patients. The arousing of these annoying gastrointestinal symptoms is interesting and deserves further investigation.
It increases the risk for many common diseases, including coronary artery disease, type 2 diabetes, dyslipidemia, hypertension, gallbladder disease and osteoarthritis, thus increasing the risk of death[ 3 , 4 ]. It is likely that severe obesity surpasses smoking as the number one cause of preventable death in the United States[ 5 ].
Because severe obesity causes a great deal of suffering related to these co-morbidities, a reduction in the general quality of life is well documented and well understood in previous reports[ 6 , 7 ].
Obesity is known to be an important risk factor for some gastro-intestinal diseases, such as gastro-esophageal reflux disease and non-alcoholic steatohepatitis and gall bladder disease[ 8 - 10 ].
Gastrointestinal complains are common in the severely obese, but there is little data specifically evaluating the impairment of gastrointestinal function in these patients or the possible etiology. A possible investigation tool, the gastrointestinal quality of life index GIQLI , is a well-validated tool for assessing the specific quality of life and gastrointestinal symptoms in patients with various gastrointestinal diseases[ 11 ].
This questionnaire was used for many gastrointestinal diseases to investigate the changes before and after surgical treatment, including gastric cancer, reflux disease, achalasia, obesity and diabetes[ 12 - 17 ]. These data are very important for investigating the etiology and therapeutic effect of associated gastrointestinal disease in severely obese patients.
In this study, we examine the differences in the GIQLI between severely obese patients and normal controls, and evaluate the relationship of various clinical parameters with the difference in GIQLI. The study was approved by the human-research review board at Min-Sheng General Hospital. This prospective study of consecutive patients was part of an extensive preoperative evaluation and data collection on patients with severe obesity referred for laparoscopic bariatric surgery for weight reduction in Min-Sheng General Hospital, Taiwan.
Another normal healthy subjects matched by age and sex were included as the normal control group. The subjects in the normal control group were volunteers who had no symptoms and received an annual health check-up at this hospital. The obesity-related co-morbidities were recorded, and the presence of metabolic syndromes was documented. Demographic and laboratory data were collected at the pre-operative evaluation.
All of the patients and normal controls received a life quality questionnaire evaluation using the GIQLI, a item-questionnaire[ 11 ]. It includes 36 items covering four domains. Three domains belong to the general quality of life: physical function 7 questions , emotional function 5 questions and social function 5 questions. One domain is specific to gastrointestinal symptoms 19 questions. Each question is scored from zero to four zero being the worst and four being the best.
The maximum score is Statistical analysis SPSS version A two-tailed t test was used for comparison of the total scores and the scores in each subgroup of items between the two groups.
All of the data were recorded on standardized data collection forms, which were transferred into a commercially available electronic database system for personal computers and analyzed. The mean age and BMI of the severely obese patients were There was no difference in the age, sex ratio, education level and martial ratio between the two groups, but the mean BMI was significantly higher in the severely obesity group Hypertension, followed by hyperglycemia, was the most common abnormal criteria in the severely obese patients.
Approximately half of them were married.
Impairment of gastrointestinal quality of life in severely obese patients
Gastrointestinal Quality of Life index - 10 items (GIQLI-10)
Gastrointestinal Quality of Life index (GIQLI)
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