Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Baronissi, Italy.
Neurogastroenterol Motil. 2021 May;33(5):e14092. doi: 10.1111/nmo.14092. Epub 2021 Feb 7.
Psychological stress and anxiety, such those generated by forced quarantine, affect gastrointestinal symptoms course in patients with functional gastrointestinal disorders. Thus, our aim was to assess, in a cohort of patients regularly followed up in a devoted outpatient clinic of Southern Italy, the association between their gastrointestinal symptoms changes, stress, and anxiety reported during the Italian lockdown.
We recruited patients from the outpatient clinic of the University of Salerno, devoted to functional gastrointestinal disorders, selecting only patients for whom an evaluation was available in the last 6 months before the lockdown. Gastrointestinal symptoms were evaluated at each visit through standardized questionnaire and pooled in a database. On 45th days from the beginning of the lockdown, patients were re-assessed by phone with the same questionnaire. Anxiety and stress levels were assessed through a self-administered online questionnaire based on Generalized Anxiety Disorder 7 test and Perceived Stress Scale 10 test.
The intensity-frequency scores of several upper gastrointestinal symptoms improved (Wilcoxon test <0.05). Higher anxiety levels had a higher risk of worsening chest pain (OR 1.3 [1.1-1.7]), waterbrash (OR 1.3 [1.0-1.7]), epigastric burning (OR 1.3 [1.0-1.6]), and abdominal pain (OR 1.6 [1.0-2.3]). When compared to the interval preceding the outbreak, half of the patients declared their symptoms remained unchanged, 13.6% worsened, and 36.4% improved.
During the COVID-19 quarantine, there was an improvement of the majority of upper gastrointestinal symptoms in our patients, and anxiety seems an important risk of worsening few of them.
心理压力和焦虑，如因强制隔离而产生的压力和焦虑，会影响功能性胃肠疾病患者的胃肠症状。因此，我们的目的是评估在意大利南部一家专门的门诊诊所定期随访的患者队列中，他们的胃肠症状变化、在意大利封锁期间报告的压力和焦虑与胃肠症状之间的关系。
我们从萨勒诺大学的门诊诊所招募了患者，该诊所专门研究功能性胃肠疾病，只选择在封锁前的最后 6 个月内有评估的患者。通过标准化问卷在每次就诊时评估胃肠症状，并将其汇总到数据库中。在封锁开始后的第 45 天，通过电话用相同的问卷重新评估患者。通过基于广泛性焦虑障碍 7 项测试和感知压力量表 10 项测试的在线自我评估问卷评估焦虑和压力水平。
多项上消化道症状的强度-频率评分有所改善（Wilcoxon 检验<0.05）。较高的焦虑水平使胸痛（OR 1.3 [1.1-1.7]）、反酸（OR 1.3 [1.0-1.7]）、上腹痛烧灼感（OR 1.3 [1.0-1.6]）和腹痛（OR 1.6 [1.0-2.3]）恶化的风险更高。与疫情爆发前的间隔相比，一半的患者报告症状保持不变，13.6%的患者症状恶化，36.4%的患者症状改善。
在 COVID-19 隔离期间，我们的患者中大多数上消化道症状有所改善，焦虑似乎是少数几个症状恶化的重要危险因素。
