title: Health-related quality of life in patients with Barrett's esophagus.
abstract: BACKGROUND
  Gastroesophageal reflux disease (GERD) has become a major health problem globally, affecting patients' health-related quality of life (HRQOL). Barrett's esophagus (BE) is a precancerous lesion associated with GERD. BE patients might not only suffer from HRQOL losses by GERD but also face psychological distress due to the increased risk of developing cancer. However, the majority of patients in Asia have shorter BE segment which is different from the West. This study aimed to determine whether the HRQOL in BE patients were worse than in healthy referents in Taiwan.
  
  
  METHODS
  Patients who received referral esophagogastroduodenoscopy for various symptoms were evaluated for the existence of BE. Lesions were judged as endoscopically suspected esophageal metaplasia (ESEM) if they showed morphological resemblances to BE by endoscopy. The diagnosis of BE was confirmed by histology with intestinal metaplasia or gastric metaplasia based on the Montreal definition. The World Health Organization Quality of Life (WHOQOL-BREF) was administered to BE patients before treatment. For each BE patient, we selected 2 age-, sex-, educational background and municipality-matched healthy referents, sampled by simple randomization method from a national survey in Taiwan. Multiple linear regression models were constructed to control the potential confounders.
  
  
  RESULTS
  A total of 84 patients diagnosed with BE were enrolled as BE group and then compared with 168 healthy referents. The BE group had significantly lower WHOQOL-BREF scores than those of healthy referents in the physical domain (P < 0.05) but higher scores in the environment domain (P < 0.05). In the physical domain, the BE group had significantly lower scores in various facets, including pain, discomfort, sleep and rest and dependence on medications or treatments. There was no significant difference in social and psychological domains between the BE group and healthy referents.
  
  
  CONCLUSIONS
  BE patients suffer from poor sleep and rest and high dependence on medications, which significantly reduce their quality of life. Individual facets of each domain warrants a better clinical healthcare to improve quality of life of BE patients.
authors.affiliation: Department of Internal Medicine, E-Da Hospital, I-Shou University, No.1, Yi-Da Rd., Kaohsiung, 824, Taiwan.|School of Medicine and Big Data Research Centre, Fu Jen Catholic University, No.510, Zhongzheng Rd., Xinzhuang Dist., New Taipei City, 24205, Taiwan.
authors.forename: Chi-Yang
authors.initials: CY
authors.lastname: Chang
authors.affiliation: National Health Research Institutes, National Institute of Environmental Health Sciences, No.35, Keyan Rd., Zhunan Township, Miaoli County, 35053, Taiwan.|Department of Environmental and Occupational Medicine, National Taiwan University Hospital, No.7, Chung Shan S. Rd., Taipei, 10002, Taiwan.|Department of Neurology, National Taiwan University Hospital, No.7, Chung Shan S. Rd., Taipei, 10002, Taiwan.|Institute of Occupational Medicine and Industrial Hygiene, College of Public Health, National Taiwan University, No.7, Chung Shan S. Rd., Taipei, 10002, Taiwan.
authors.forename: Lukas Jyuhn-Hsiarn
authors.initials: LJ
authors.lastname: Lee
authors.affiliation: Department of Public Health, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, No. 1, University Rd., Tainan, Taiwan.|Department of Internal Medicine, National Cheng Kung University Hospital, No. 1, University Rd., Tainan, Taiwan.|Department of Environmental and Occupational Medicine, National Cheng Kung University Hospital, No. 1, University Rd., Tainan, Taiwan.
authors.forename: Jung-Der
authors.initials: JD
authors.lastname: Wang
authors.affiliation: Department of Internal Medicine, E-Da Hospital, I-Shou University, No.1, Yi-Da Rd., Kaohsiung, 824, Taiwan.
authors.forename: Ching-Tai
authors.initials: CT
authors.lastname: Lee
authors.affiliation: Department of Internal Medicine, E-Da Hospital, I-Shou University, No.1, Yi-Da Rd., Kaohsiung, 824, Taiwan.
authors.forename: Chi-Ming
authors.initials: CM
authors.lastname: Tai
authors.affiliation: Department of Internal Medicine, E-Da Hospital, I-Shou University, No.1, Yi-Da Rd., Kaohsiung, 824, Taiwan.
authors.forename: Tao-Qian
authors.initials: TQ
authors.lastname: Tang
authors.affiliation: School of Medicine, Fu Jen Catholic University, No.510, Zhongzheng Rd., Xinzhuang Dist., New Taipei City, 24205, Taiwan. jawtown@gmail.com.
authors.forename: Jaw-Town
authors.initials: JT
authors.lastname: Lin
mesh_terms: D000368:Aged; D001294:Attitude to Health; D001471:Barrett Esophagus / Q000523:psychology*; D005260:Female; D005764:Gastroesophageal Reflux / Q000523:psychology*; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011788:Quality of Life / Q000523:psychology*; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D013624:Taiwan
keywords: Barrett’s esophagus; GERD; Quality of life