Abstract
Background: Rheumatoid arthritis (RA) and collagen disease patients sometimes exhibit digestive symptoms as a result of medications such as prednisolone (PSL) and non-steroidal antiinflammatory drugs; however, the number of patients with gastrointestinal symptoms is unclear because only a few cases have been reported.
Aim and Method: We investigated patient background, proton pump inhibitor (PPI) and PSL usage rate, and QOL in patients with gastrointestinal symptoms using the Global Overall Severity (GOS) and Gastrointestinal Symptom Rating Scale (GSRS) for outpatients of our department. We observed the change in the GOS score before and 2 weeks after administering esomeprazole (EPZ)in patients with a GOS score of＞3 who wanted a change in PPI.
Results: The number of surveyed patients was 152(RA,n＝68;systemic lupus erythematous ［SLE］,n＝20;M :F ratio,20:132;age,56.9±13.8 years; BMI,21.03±2.46). The GSRS scores in all outpatients were higher than that in the control (1.68±0.71 vs.1.53), which indicates that the QOL deteriorated in RA and collagen disease patients with gastrointestinal symptoms. A high incidence of constipation was observed in RA (1.95±1.08) and SLE (1.97±0.80) patients that was independent of the use of PPI or PSL. Stomach acid reflux, stomach conditions, and dyspepsia persisted in SLE patients despite PPI treatment. In 29 patients, EPZ treatment significantly improved the heavy feeling in the stomach(p＝0.0186).
Discussion: This study showed that digestive symptoms persisted in RA and collagen disease patients despite PPI treatment. Further studies are needed to improve the QOL in patients with gastrointestinal symptoms.
