Quality of life in patients with upper gastrointestinal symptoms: Results from the Domestic/International Gastroenterology Surveillance Study (DIGEST)

Background: Our purpose was to evaluate the impact of upper gastrointestinal (GI) symptoms on quality of life (QoL), which was assessed using the Psychological General Well-Being index (PGWBI) and the three-item Interference with Daily Life Index (IDLI). Methods: The Domestic/International Gastroenterology Surveillance Study (DIGEST) was conducted among 5581 respondents (mean age 44 years) from 10 countries (seven European countries plus Canada, USA and Japan). Results: Approximately 25% of the respondents reported conditions such as hypertension, asthma or diabetes, and a mean of 46.4% reported at least one GI symptom. The most frequent symptoms were heartburn, diarrhoea and postprandial fullness. Approximately 10-20% of the respondents reporting individual symptoms experienced these several times a week. Symptoms were considered as severe or interfering 'quite a lot' with daily activities by at least 7.3% and 4.8% of respondents, respectively. PGWBI scores varied from 71.82 (Italy) to 79.43 (Switzerland) and daily activity scores from 88.62 (USA) to 97.78 (Switzerland). Female gender, medical conditions and presence of GI symptoms were associated with significantly impaired wellbeing and daily life. PGWBI and IDLI scores were lower among respondents with relevant upper GI symptoms than non-upper GI symptoms. Among upper GI symptom groups, subjects with ulcer-like symptoms had lower scores than patients with GERD-like or dysmotility-like symptoms. PGWBI and IDLI scores were found to discriminate between respondents reporting different symptom frequencies and severities. Conclusions: Results from the DIGEST demonstrate on a large scale the importance of GI symptoms in daily life and their influence on QoL.