Gastrointestinal symptoms in patients with cirrhosis: a longitudinal study before and after liver transplantation
(2013) In Scandinavian Journal of Gastroenterology 48(11). p.1308-1316- Abstract
- Objective. Gastrointestinal (GI) symptoms are common in cirrhosis and have an impact on quality of life. Their pathophysiology and their relation to energy intake have not been fully elucidated and the effect of liver transplantation on GI symptoms has not been studied. We aimed to prospectively evaluate GI symptoms and their determinants before and after transplantation and their potential relation with energy intake in cirrhosis. Methods. A total of 108 cirrhotic liver transplant candidates completed the Gastrointestinal Symptom Rating Scale (GSRS) and the hospital anxiety and depression scale. Fasting serum glucose and insulin were measured in all patients. Serum thyrotropin, free T3/T4, cortisol, free testosterone, estradiol,... (More)
- Objective. Gastrointestinal (GI) symptoms are common in cirrhosis and have an impact on quality of life. Their pathophysiology and their relation to energy intake have not been fully elucidated and the effect of liver transplantation on GI symptoms has not been studied. We aimed to prospectively evaluate GI symptoms and their determinants before and after transplantation and their potential relation with energy intake in cirrhosis. Methods. A total of 108 cirrhotic liver transplant candidates completed the Gastrointestinal Symptom Rating Scale (GSRS) and the hospital anxiety and depression scale. Fasting serum glucose and insulin were measured in all patients. Serum thyrotropin, free T3/T4, cortisol, free testosterone, estradiol, dehydroepiandrosterone sulfate, interleukin-6 and tumor necrosis factor-alpha were measured in a subgroup of 80 patients. Transplant recipients were followed for 1 year. A separate cohort of 40 cirrhotic patients underwent a high-caloric satiation drinking test (SDT). Results. GI symptoms were more severe in cirrhotics compared to controls from the general population. In regression analysis, the total GSRS score was independently related to lactulose, anxiety and low free testosterone (p < 0.05 for all). Four out of six GSRS domain scores improved significantly 1 year post-transplant (p < 0.05) but the total GSRS score remained higher compared to controls. GI symptoms predicted ingestion of fewer calories at SDT compared to other patients and controls (p < 0.05). Conclusions. Psychological distress, lactulose treatment and low testosterone are predictors of GI symptoms which are common among cirrhotic transplant candidates. They are also associated with decreased energy intake as measured by a SDT. GI symptoms remain of concern post-transplant. (Less)
Please use this url to cite or link to this publication:
https://lup.lub.lu.se/record/4201038
- author
- Kalaitzakis, Evangelos LU ; Josefsson, Axel ; Castedal, Maria ; Henfridsson, Pia ; Bengtsson, Maria ; Andersson, Bengt and Bjornsson, Einar
- organization
- publishing date
- 2013
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- diabetes mellitus, energy intake, health-related quality of life, liver, cirrhosis, liver transplantation, proton pump inhibitor, psychological, distress, satiation drinking test, sex hormones, systemic inflammation
- in
- Scandinavian Journal of Gastroenterology
- volume
- 48
- issue
- 11
- pages
- 1308 - 1316
- publisher
- Taylor & Francis
- external identifiers
-
- wos:000326716000011
- scopus:84885895084
- ISSN
- 1502-7708
- DOI
- 10.3109/00365521.2013.836755
- language
- English
- LU publication?
- yes
- id
- 434318f2-8291-4de2-8f43-5bdf731fd923 (old id 4201038)
- date added to LUP
- 2016-04-01 14:54:16
- date last changed
- 2024-01-10 10:06:27
@article{434318f2-8291-4de2-8f43-5bdf731fd923,
abstract = {{Objective. Gastrointestinal (GI) symptoms are common in cirrhosis and have an impact on quality of life. Their pathophysiology and their relation to energy intake have not been fully elucidated and the effect of liver transplantation on GI symptoms has not been studied. We aimed to prospectively evaluate GI symptoms and their determinants before and after transplantation and their potential relation with energy intake in cirrhosis. Methods. A total of 108 cirrhotic liver transplant candidates completed the Gastrointestinal Symptom Rating Scale (GSRS) and the hospital anxiety and depression scale. Fasting serum glucose and insulin were measured in all patients. Serum thyrotropin, free T3/T4, cortisol, free testosterone, estradiol, dehydroepiandrosterone sulfate, interleukin-6 and tumor necrosis factor-alpha were measured in a subgroup of 80 patients. Transplant recipients were followed for 1 year. A separate cohort of 40 cirrhotic patients underwent a high-caloric satiation drinking test (SDT). Results. GI symptoms were more severe in cirrhotics compared to controls from the general population. In regression analysis, the total GSRS score was independently related to lactulose, anxiety and low free testosterone (p < 0.05 for all). Four out of six GSRS domain scores improved significantly 1 year post-transplant (p < 0.05) but the total GSRS score remained higher compared to controls. GI symptoms predicted ingestion of fewer calories at SDT compared to other patients and controls (p < 0.05). Conclusions. Psychological distress, lactulose treatment and low testosterone are predictors of GI symptoms which are common among cirrhotic transplant candidates. They are also associated with decreased energy intake as measured by a SDT. GI symptoms remain of concern post-transplant.}},
author = {{Kalaitzakis, Evangelos and Josefsson, Axel and Castedal, Maria and Henfridsson, Pia and Bengtsson, Maria and Andersson, Bengt and Bjornsson, Einar}},
issn = {{1502-7708}},
keywords = {{diabetes mellitus; energy intake; health-related quality of life; liver; cirrhosis; liver transplantation; proton pump inhibitor; psychological; distress; satiation drinking test; sex hormones; systemic inflammation}},
language = {{eng}},
number = {{11}},
pages = {{1308--1316}},
publisher = {{Taylor & Francis}},
series = {{Scandinavian Journal of Gastroenterology}},
title = {{Gastrointestinal symptoms in patients with cirrhosis: a longitudinal study before and after liver transplantation}},
url = {{http://dx.doi.org/10.3109/00365521.2013.836755}},
doi = {{10.3109/00365521.2013.836755}},
volume = {{48}},
year = {{2013}},
}