Document Detail

The burden of upper gastrointestinal endoscopy in patients with Barrett's esophagus.
MedLine Citation:
PMID:  17019759     Owner:  NLM     Status:  MEDLINE    
BACKGROUND AND STUDY AIMS: Patients with Barrett's esophagus are recommended to undergo regular surveillance with upper gastrointestinal endoscopy, an invasive procedure that may cause anxiety, pain, and discomfort. We assessed to what extent patients perceived this procedure as burdensome. PATIENTS AND METHODS: A total of 192 patients with Barrett's esophagus were asked to fill out questionnaires at 1 week and immediately before endoscopy, and at 1 week and 1 month afterwards. Four variables were assessed: (i) pain and discomfort experienced during endoscopy; (ii) symptoms; (iii) psychological burden, i. e., anxiety, depression and distress levels (Hospital Anxiety and Depression scale, Impact of Event Scale); and (iv) perceived risk of developing adenocarcinoma. RESULTS: At least one questionnaire was returned by 180 patients (94 %), 151 completed all four (79 %). Of all patients, only 14 % experienced the endoscopy as painful. However, 59 % reported it to be burdensome. Apart from an increase in throat ache (47 % after endoscopy versus 12 % before), the procedure did not cause physical symptoms. Patients' anxiety, depression, and distress levels were significantly increased in the week before endoscopy compared with the week after. Patients perceiving their risk of developing adenocarcinoma as high reported higher levels of psychological distress and that the procedure was a greater burden. CONCLUSIONS: Upper gastrointestinal endoscopy is burdensome for many patients with Barrett's esophagus and causes moderate distress. Perception of a high risk of adenocarcinoma may increase distress and the burden experienced from the procedure. The benefits of endoscopic surveillance for patients with Barrett's esophagus should be weighed against its drawbacks, including the short-term burden for patients.
M E Kruijshaar; M Kerkhof; P D Siersema; E W Steyerberg; M Y V Homs; M-L Essink-Bot;
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Endoscopy     Volume:  38     ISSN:  0013-726X     ISO Abbreviation:  Endoscopy     Publication Date:  2006 Sep 
Date Detail:
Created Date:  2006-10-03     Completed Date:  2007-01-04     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0215166     Medline TA:  Endoscopy     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  873-8     Citation Subset:  IM    
Department of Public Health, Erasmus MC, University Medical Center Rotterdam, The Netherlands.
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MeSH Terms
Adenocarcinoma / diagnosis
Barrett Esophagus / diagnosis*,  psychology
Cost of Illness*
Endoscopy, Gastrointestinal* / psychology
Esophageal Neoplasms / diagnosis
Middle Aged
Stress, Psychological

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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