Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2009 Jun;7(6):613-23.
doi: 10.1016/j.cgh.2009.02.024. Epub 2009 Mar 10.

Health-related quality of life in patients with Barrett's esophagus: a systematic review

Seth D Crockett  1 , Quinn K Lippmann, Evan S Dellon, Nicholas J Shaheen
Affiliations

Health-related quality of life in patients with Barrett's esophagus: a systematic review

Seth D Crockett et al. Clin Gastroenterol Hepatol. 2009 Jun.

Abstract

Background & aims: Barrett's esophagus (BE) affects approximately 10% of patients with chronic gastroesophageal reflux disease (GERD). Patients with BE are at risk for reduced health-related quality of life (HRQoL) associated with GERD, in addition to the potential psychosocial stress of carrying a diagnosis of a premalignant condition with a risk of esophageal adenocarcinoma. We sought to systematically review the published literature on HRQoL of patients with BE.

Methods: We searched PubMed, PsycINFO, and Cumulative Index to Nursing and Allied Health Literature for relevant clinical trials using a defined search strategy. We also manually searched relevant scientific meeting abstracts and related article bibliographies. Eligible articles were case series, cohort studies, or clinical trials that included one or more measures of HRQoL and/or quantitatively assessed burden of disease in patients with BE. Effect sizes were calculated when possible.

Results: Our initial search identified 95 articles. After 2 physician reviews, 25 articles met inclusion criteria. Data show that BE is associated with a significant decrement in HRQoL as measured by both generic and disease-targeted instruments. In addition, patients with BE are at risk for psychological consequences such as depression, anxiety, and stress, which may be related to their increased risk of esophageal adenocarcinoma. Compared with subjects with GERD alone or the general population, a diagnosis of BE also leads to increased health care use and spending.

Conclusions: BE compromises multiple facets of patients' quality of life. Physicians and researchers should incorporate patient-reported outcomes data including HRQoL measures when treating or studying patients with BE.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Search strategy for systematic review
Figure 2
Figure 2
Pilot graph of Medical Outcomes Short Form-36 (SF-36) subdomain scores measuring generic quality of life in patients with Barrett’s esophagus compared to a healthy control population. Lower scores on the SF-36 (i.e. towards center of graph) indicate worsened quality of life. PF: Physical Functioning; RP: Role Limitations-Physical; BP: Bodily Pain; GH: General Health; VT: Vitality; SF: Social Functioning; RE: Role Limitations-Emotional; MH: Mental Health *Control data from Ware
Figure 3
Figure 3
Total scores on the Quality of Life in Reflux and Dyspepsia questionnaire (QOLRAD) measuring disease-targeted quality of life in patients with Barrett’s Esophagus compared to patients with gastroesophageal reflux disease *Control GERD data from Kulig et. al
Figure 4
Figure 4
Impact of diagnosing Barrett Esophagus. Modified from Dellon et. al Gastrointest Endosc 2007 Jan;65(1):31–5.
See this image and copyright information in PMC

References

    1. Barrett NR. Chronic peptic ulcer of the oesophagus and ‘oesophagitis’. Br J Surg. 1950;38:175–82. - PubMed
    1. Allison PR, Johnstone AS. The oesophagus lined with gastric mucous membrane. Thorax. 1953;8:87–101. - PMC - PubMed
    1. O’Connor JB, Falk GW, Richter JE. The incidence of adenocarcinoma and dysplasia in Barrett’s esophagus: report on the Cleveland Clinic Barrett’s Esophagus Registry. Am J Gastroenterol. 1999;94:2037–42. - PubMed
    1. Cameron AJ, Ott BJ, Payne WS. The incidence of adenocarcinoma in columnar-lined (Barrett’s) esophagus. N Engl J Med. 1985;313:857–9. - PubMed
    1. Drewitz DJ, Sampliner RE, Garewal HS. The incidence of adenocarcinoma in Barrett’s esophagus: a prospective study of 170 patients followed 4.8 years. Am J Gastroenterol. 1997;92:212–5. - PubMed

Publication types

MeSH terms