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Alloveda Liver Update: Correlation of Gl symptoms with nutritional status and health-related QoL in patients with liver cirrhosis

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eMediNexus    06 May 2021

Gastrointestinal symptoms results in decreased food intake which can in turn, can lead to nutritional deficiency and significant morbidity. However, data regarding the prevalence of gastrointestinal symptoms and their potential interrelationship with malnutrition and health-related quality of life (QoL) in cirrhosis are scarce. The objective of the current study was to prospectively measure gastrointestinal symptoms, malnutrition, and QoL in patients with cirrhosis.

The authors included two validated questionnaires to evaluate gastrointestinal symptoms (gastrointestinal symptom rating scale (GSRS)) and health-related QoL (SF-36) in 128 consecutive cirrhotics (mean age 57 years, Child-Pugh score 8.6, MELD score 13.2). The results of these questionnaires were contrasted with those of controls from the general population. Nutritional status was evaluated by anthropometry and estimation of recent weight change. 

The outcome of the study showed that cirrhotic patients showed higher gastrointestinal symptom severity (total GSRS score: 1.53, 95% CI 1.50–1.55 versus 2.21, 95% CI 2.04–2.38) and profound reductions in the SF-36 physical (47.0 95% CI 45.0–49.0 versus 37.9, 95% CI 35.7–40.1) and mental component summary scores (51.0 95% CI 49.0–53.0 versus 39.2 95% CI 36.7–41.6) in comparison to controls. No significant difference was reported in any GSRS domain between patients with and those without malnutrition. Multivariate analysis showed that gastrointestinal symptom severity was related to the Child-Pugh score (beta = 0.10), daily lactulose use (beta = 0.65), and the presence of gastrointestinal comorbidities (beta = 0.51). Gastrointestinal symptom severity was independently correlated to Negative weight change (beta = − 0.72) and the SF-36 physical (beta = − 4.26) and mental (beta = − 4.53) summaries.

Thus, the study concluded that increased severity of gastrointestinal symptoms are seen in patients with cirrhosis, which are linked to recent weight loss and reduced health-related QoL. Moreover, the severity of gastrointestinal symptoms appears to be associated with the severity of cirrhosis.

Source: Kalaitzakis E, Simrén M, Olsson R, Henfridsson P, Hugosson I, Bengtsson M, Björnsson E. Gastrointestinal symptoms in patients with liver cirrhosis: associations with nutritional status and health-related quality of life. Scand J Gastroenterol. 2006 Dec;41(12):1464-72

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