Among patients with eosinophilic esophagitis (EoE), hypervigilance and symptom-distinct anxiousness are critical for understanding self-reported patient outcomes, according to study benefits published in Gastroenterology.
Increasingly, hypervigilance and symptom-distinct anxiousness are becoming recognized as critical considerations for patient reported outcomes in esophageal illness and may perhaps clarify dysphagia symptoms improved than physiological information. To investigate, a retrospective evaluation of an EoE patient registry was performed.
A total of 103 patients had full information for the following 7 parameters and questionnaires and have been incorporated in the evaluation: eosinophils per higher energy field , endoscopic reference score (EREFS), distal distensibility plateau (FLIP), Brief Esophageal Dysphagia Questionnaire (BEDQ), Visual Dysphagia Question of EoE Activity Index (EEsAI-VDQ), Northwestern Esophageal Quality of Life scale (NEQOL), and Esophageal Hypervigilance and Anxiety Scale (EHAS).
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The majority of patients have been male (69.9%) and the typical age was 40.66 years. The principal cause most patients presented for esophagogastroduodenoscopy (EGD) was dysphagia (73%), with quite handful of reporting heartburn/reflux (4.9%) or chest discomfort (1.9%).
Symptom-distinct anxiousness and hypervigilance have been considerable predictors of dysphagia symptoms, difficulty swallowing diverse foods, and poorer overall health-connected good quality of life (HRQOL). The most critical predictor of BEDQ severity, EEsAI-VDQ severity, and poor HRQOL was esophageal symptom-distinct anxiousness, accounting for 44.8%, 26%, and 55.3% of variance, respectively. Hypervigilance was critical, although to a lesser extent.
Recent meals impaction was a considerable predictor of elevated symptom-distinct anxiousness, but not hypervigilance. Use of proton-pump inhibitors was a predictor of significantly less hypervigilance.
This study was not with out limitations. Though study information have been collected prospectively, they have been reviewed retrospectively. Additionally, information have been collected from a single center, have been cross-sectional in nature, and only assessed the 4 weeks prior to collection. Demographic information have been not collected and as a result associations with hypervigilance and anxiousness could not be assessed. All questionnaires have been completed just before EGD and FLIP procedures, which may perhaps have amplified anxiousness scores. No post-process measurements have been performed to account for this.
According to researchers, “Hypervigilance to, and anxiety about, EoE symptoms are important clinical considerations when evaluating patient outcomes that should be routinely evaluated.”
Disclosure: Some study authors declared affiliations with biotech, pharmaceutical, and/or device firms. Please see the original reference for a complete list of authors’ disclosures.
Reference
Taft TH, Carlson DA, Simons M, et al. Esophageal hypervigilance and symptom specific anxiety in patients with eosinophilic esophagitis. Gastroenterol. Published on-line June 18, 2021. doi:10.1053/j.gastro.2021.06.023
This write-up initially appeared on Gastroenterology Advisor
