Olga Brawman-Mintzer1, Valerie Durkalski2, Qi Wu2, Joseph Romagnuolo2, Evan Fogel3, Paul Tarnasky4, Giuseppe Aliperti5, Martin Freeman6, Richard Kozarek7, Priya Jamidar8, Mel Wilcox9, Grace Elta10, Kyle Orrell11, April Wood2, Patrick Mauldin2, Jose Serrano12, Douglas Drossman13, Patricia Robuck12, Peter Cotton2. 1. 1] Digestive Disease Center, Medical University of South Carolina, Charleston, South Carolina, USA [2] Ralph H. Johnson VAMC, Charleston, South Carolina, USA. 2. Digestive Disease Center, Medical University of South Carolina, Charleston, South Carolina, USA. 3. Indiana University, Indianapolis, Indiana, USA. 4. Methodist Dallas Medical Center, Dallas, Texas, USA. 5. Midwest Therapeutic Endoscopy Consultants, St Louis, Missouri, USA. 6. University of Minnesota Medical School, Minneapolis, Minnesota, USA. 7. Virginia Mason Medical Center, Seattle, Washington, USA. 8. Yale University, Newhaven, Connecticut, USA. 9. University of Alabama, Birmingham, Alabama, USA. 10. University of Michigan, Ann Arbor, Michigan, USA. 11. 1] Digestive Disease Center, Medical University of South Carolina, Charleston, South Carolina, USA [2] Methodist Dallas Medical Center, Dallas, Texas, USA. 12. National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, Maryland, USA. 13. University of North Carolina and Drossman Gastroenterology PLLC, Chapel Hill, North Carolina, USA.
Abstract
OBJECTIVES:Patients with several painful functional gastrointestinal disorders (FGIDs) are reported to have a high prevalence of psychosocial disturbance. These aspects have not been studied extensively in patients with suspected Sphincter of Oddi dysfunction (SOD). METHODS: A total of 214 patients with post-cholecystectomy pain and suspected SOD were enrolled in seven US centers in a multicenter-randomized trial (Evaluating Predictors and Interventions in Sphincter of Oddi Dysfunction). Baseline assessments included pain descriptors and burden, structured psychosocial assessments of anxiety/depression, coping, trauma, and health-related quality of life. Patients with high levels of depression, suicidal ideation, or psychosis were excluded. RESULTS:The study population (92% female, mean age 38) reported anxiety (9%), depression (8%), past sexual trauma (18%), and physical abuse (10%). Of the total screened population (n=1460), 3.9% of the patients were excluded because of the presence of defined severe psychological problems. The mean medical outcomes study short-form-36 (SF-36) physical and mental composite scores were 38.70 (s.d.=7.89) and 48.74 (s.d.=9.60), respectively. Most subjects reported symptoms of other FGIDs. There were no correlations between the extent of the pain burden in the 3 months before enrollment and the baseline anxiety scores or victimization history. However, those with greater pain burden were significantly more depressed. There were no meaningful differences in the psychosocial parameters in subjects with or without irritable bowel, and those who had cholecystectomy for stones or functional gallbladder disease. Those declining randomization were comparable to those randomized. CONCLUSIONS:Psychosocial comorbidity in SOD is high. However, it does not appear to differ significantly from that reported in surveys of age- and gender-matched general populations, and may be lower than reported with other FGIDs.
RCT Entities:
OBJECTIVES:Patients with several painful functional gastrointestinal disorders (FGIDs) are reported to have a high prevalence of psychosocial disturbance. These aspects have not been studied extensively in patients with suspected Sphincter of Oddi dysfunction (SOD). METHODS: A total of 214 patients with post-cholecystectomy pain and suspected SOD were enrolled in seven US centers in a multicenter-randomized trial (Evaluating Predictors and Interventions in Sphincter of Oddi Dysfunction). Baseline assessments included pain descriptors and burden, structured psychosocial assessments of anxiety/depression, coping, trauma, and health-related quality of life. Patients with high levels of depression, suicidal ideation, or psychosis were excluded. RESULTS: The study population (92% female, mean age 38) reported anxiety (9%), depression (8%), past sexual trauma (18%), and physical abuse (10%). Of the total screened population (n=1460), 3.9% of the patients were excluded because of the presence of defined severe psychological problems. The mean medical outcomes study short-form-36 (SF-36) physical and mental composite scores were 38.70 (s.d.=7.89) and 48.74 (s.d.=9.60), respectively. Most subjects reported symptoms of other FGIDs. There were no correlations between the extent of the pain burden in the 3 months before enrollment and the baseline anxiety scores or victimization history. However, those with greater pain burden were significantly more depressed. There were no meaningful differences in the psychosocial parameters in subjects with or without irritable bowel, and those who had cholecystectomy for stones or functional gallbladder disease. Those declining randomization were comparable to those randomized. CONCLUSIONS:Psychosocial comorbidity in SOD is high. However, it does not appear to differ significantly from that reported in surveys of age- and gender-matched general populations, and may be lower than reported with other FGIDs.
Authors: Douglas G Adler; John G Lieb; Jonathan Cohen; Irving M Pike; Walter G Park; Maged K Rizk; Mandeep S Sawhney; James M Scheiman; Nicholas J Shaheen; Stuart Sherman; Sachin Wani Journal: Am J Gastroenterol Date: 2014-12-02 Impact factor: 10.864
Authors: Peter B Cotton; Valerie Durkalski; Joseph Romagnuolo; Qi Pauls; Evan Fogel; Paul Tarnasky; Giuseppe Aliperti; Martin Freeman; Richard Kozarek; Priya Jamidar; Mel Wilcox; Jose Serrano; Olga Brawman-Mintzer; Grace Elta; Patrick Mauldin; Andre Thornhill; Robert Hawes; April Wood-Williams; Kyle Orrell; Douglas Drossman; Patricia Robuck Journal: JAMA Date: 2014-05 Impact factor: 56.272
Authors: Gregory A Coté; Haley Nitchie; B Joseph Elmunzer; Richard S Kwon; Field F Willingham; Sachin Wani; Daniel Mullady; Amitabh Chak; Vikesh Singh; Adam Slivka; Shyam Varadarajulu; Martin Freeman; Srinivas Gaddam; Priya Jamidar; Paul Tarnasky; Lydia Foster; Peter B Cotton Journal: Clin Gastroenterol Hepatol Date: 2021-03-11 Impact factor: 13.576