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Gastrointestinal Symptom Distress is Associated with Worse Mental and Physical Health Related Quality of Life.

Gastrointestinal Symptom Distress is Associated with Worse Mental and Physical Health Related Quality of Life.
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O'neill TJ, Raboud JM, Tinmouth J, Rourke SB, Rueda S, Hart TA, Cooper C, Rachlis A, Burchell AN, ,


O'neill TJ, Raboud JM, Tinmouth J, Rourke SB, Rueda S, Hart TA, Cooper C, Rachlis A, Burchell AN, , (click to view)

O'neill TJ, Raboud JM, Tinmouth J, Rourke SB, Rueda S, Hart TA, Cooper C, Rachlis A, Burchell AN, ,

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Journal of acquired immune deficiency syndromes (1999) 2017 02 07() doi 10.1097/QAI.0000000000001309

Abstract
BACKGROUND
The prevalence of self-reported GI symptoms and distress is high, but few studies have quantified their impact on HRQOL.

METHODS
We conducted a prospective cohort study of HIV patients in care in Ontario, Canada (2007-2014). General linear mixed models were used to assess the impact of GI symptoms (diarrhea/soft stool, nausea/vomiting, bloating/painful abdomen, loss of appetite, weight loss/wasting) and distress (range: 0 to 4) on physical and mental HRQOL summary scores (range: 0 to 100) measured by the Medical Outcomes Survey SF-36.

RESULTS
A total of 1787 participants completed one or more questionnaires (median 3 (IQR 1,4)). At baseline, 59.0% were men who had sex with men, 53.7% Caucasian, median age 45 (IQR: 38, 52), median CD4+ count 457 (IQR: 315, 622), and 71.0% had undetectable HIV viremia. The median mental and physical HRQOL scores were 48.5 (IQR: 36.4, 55.7) and 51.2 (IQR: 44.4, 55.1), respectively. In adjusted models, compared to those reporting no symptoms, all GI symptom distress scores from 2 (‘have symptom, bothers me a little’) to 4 (‘have symptom, bothers a lot’) were associated with lower mental HRQOL. Loss of appetite distress scores ≥1;scores ≥2 for diarrhea, nausea/vomiting, and bloating; and a score ≥3 for weight loss were independently associated with lower physical HRQOL scores (p <0.0001). Increasing GI symptom distress is associated with impaired mental and physical HRQOL (p <0.0001). CONCLUSIONS
Increasing GI symptom distress is associated with impaired mental and physical HRQOL. Identifying, treating, and preventing GI symptoms may reduce overall symptom burden and improve HRQOL for HIV patients.

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