INFLUENCE OF ACCOMPANYING GASTRODUODENAL PATHOLOGY ON CLINICAL SYMPTOMS AND QUALITY OF LIFE OF PATIENTS WITH CHRONIC PANCREATITIS

Abstract

SUMMARY. In spite of the considerable advance in the research of pancreatic pathology, clinical symptoms and syndromes, along with the life quality evaluation with the use of SF-36 and GSRS questionnaires of patients with chronic pancreatitis combined with comorbid pathology of gastroduodenal zone (GDZ) organs continues to be studied and substantiated insufficiently. The aim – to study the clinical symptoms and assess life quality using the SF-36 and GSRS questionnaires in the comorbidity of chronic pancreatitis with H. Pylori-associated chronic gastritis. Material and Methods. 30 outpatients with CP and 117 with CP in comorbidity with chronic gastritis (CG) associated with H. Pylori were examined. A combined assessment of clinical manifestations (symptoms/syndromes) of patients with CP and CP with H. Pylori-associated chronic gastritis was conducted. For the reliable assessment of life quality, groups of patients were compared: the control group, patients with CP and patients with comorbidity. The physical and psychological components were evaluated using the SF-36 questionnaire. Indicators of the life quality components of patients of both groups were also studied according to the scales of the GSRS questionnaire. Results. The clinical symptoms in the comorbidity of CP with accompanying gastroduodenal disorders had specific features compared to those in isolated CP: a smaller number of patients had a pain syndrome (93.3 % vs. 100.0 %); dyspepsia syndrome was found in all the patients with comorbid pathology (100.0 % vs. 86.7 %), a significantly larger number of such patients had nausea (63.3 % vs. 26.5 %), a feeling of heaviness (26.7 % vs. 18,8 %), diarrhea (33.3 % vs. 17.9 %), alternating diarrhea and constipation (26.7 % vs. 23.1 %), enteropancreatic and asthenoneurotic syndromes were detected with a slight advantage in patients with comorbidity – 72.6 % against 66.7 %, and 90.0 % against 83.8 %. It was found that the average total index of the physical component of patients with CP with comorbidity compared to that in the group of isolated CP according to the SF-36 questionnaire was found to be significantly lower: the difference between the values of the average total index of the physical component of life quality of the patients from the comparison groups was 10.42 points (11.2 %). Conclusion. It was established that the difference between the total indicators of the psychological component scales of the life quality according to the SF-36 questionnaire of the groups of patients with CP and patients with comorbidity is 9.71 (11.5 %), which proved that the psychological state of patients with CP with concomitant gastroduodenal changes was significantly worse. The total index of the GRSR scales in the group of patients with CP+GDC (gastroduodenal changes) is significantly higher than of the group with isolated CP – by 1.52 times, and this proved a significantly lower quality of life according to the state of gastroenterological syndromes of the GSRS questionnaire (р≤0.05).