Several gastrointestinal symptoms have been specifically related to a deranged HRQL. Patients with constipation have lower general HRQL scores than healthy controls, as have patients with heartburn.
Appropriate treatment of gastro-oesophageal reflux disease decreased heartburn and in turn increased HRQL scores. Nausea and vomiting in patients with severe dyspepsia or gastroparesis was also associated with a decrease in HRQL. Patients who were successfully treated for their symptoms showed a significant enhancement of HRQL. The severity of abdominal pain in patients with functional bowel disease correlates with impaired HRQL and increased levels of psychological distress. When abdominal pain scores improved after treatment, so also did HRQL, as evaluated by the use of the SF-36. There was also a significant correlation between the change in scores on the IBS – QOL, a disease-specific quality of life scale for patients with IBS, and average daily pain level over two 14 day periods. The IBS – QOL scores discriminated responders to treatment from non-responders for the pain level parameter. Finally, even mild diarrhoea (assessed via diary cards and interview) was perceived as having a debilitating effect on HRQL (assessed via interview) in patients infected with HIV. In a random sample of elderly patients, role functioning scale scores discriminated patients with diarrhoea from asymptomatic controls.
The impact of faecal incontinence, an important complication of diabetes, on HRQL was investigated by Sailor et al., using the Gastrointestinal Quality of Life Index [GIQLI]. They evaluated HRQL in patients with faecal incontinence, compared with those with haemorrhoids or fissure in ano, and healthy controls. Patients with faecal incontinence manifested the lowest HRQL scores, compared to both medical and healthy control groups.
Subgroups of patients with faecal incontinence and severe constipation had the poorest HRQL scores.