Assessment of the dynamics of formation and influence of combined course of chronic cholecystitis and gastroesophageal reflux disease on quality of life of patients

Purpose: to analyze the dynamics of formation and changes in the quality of life of multimorbid patients with chronic cholecystitis and gastroesophageal reflux disease (GERD). Material and Methods. 186 patients were examined: 82 patients were diagnosed with chronic cholecystitis in combination with GERD, 58 were diagnosed-only with chronic cholecystitis and 46 were diagnosed-only with GERD. The diagnosis of GERD was established according to modern criteria adopted by the International Consensus Group that studied the reflux disease and was confirmed by the results of daily esophageal pH measurements. Chronic cholecystitis was diagnosed on the basis of complaints, laboratory and clinical data and was confirmed by ultrasound analysis. The quality of life of patients was assessed using the SF-36 questionnaire. Results. In most cases gastroesophageal reflux (GERD) develops over the background of chronic cholecystitis (53.4%) while the reverse situation occurs only in 25.5% of cases. Simultaneous development of both diseases was observed only for 18.9% of patients. In most cases (45.1 %) GERD manifests itself during the 2nd to 4th year of chronic cholecystitis. The quality of life in patients with GERD has been ascertained to be lower than in those with chronic cholecystitis. The summary index of physical health in patients with chronic cholecystitis made 171.4±0.4 scores, while in the GERD group it did not exceed 146.8±0.2. Similar tendency was observed in the summary index of psychological health: in patients with GERD it was 26.3% (p<0.05) lower than in those with chronic cholecystitis. With polymorbidity developed against the background of chronic cholecystitis, the summary index of physical health reduces from 171.4±0.4 to 140.9±1.1 scores (p<0.05), while that of psychological health — from 254.8±0.6 to 144.5±0.8. In patients with GERD, chronic cholecystitis is practically non-essential for the state of physical health, while their psychological health declines substantially: from 188.5±0.6 to 144.5±0.8 scores (p<0.05). Conclusion. The risk of GERD development against the background of chronic cholecystitis is 1.9 times higher that of the reverse process. GERD usually develops over the 2nd to 4th year of chronic cholecystitis. Development of multimorbid state decreases the quality of life for patients with GERD and chronic cholecystitis with psychological health aspects being the most affected according to SF-36 questionnaire. The primary cause of the decreased quality of life for patients diagnosed with chronic cholecystitis and GERD is the almost twofold increase in the number of GERD exacerbations per year due to formation of multimorbid state.