The Dutch Gastrointestinal Symptom Tracker for People With Cystic Fibrosis: Associations With Anxiety, Depression, and Health-Related Quality of Life

People with CF (pwCF) frequently have gastrointestinal symptoms (GI), including abdominal pain and irregular bowel movements. These are often embarrassing, difficult to report, and frequently missed. Thus, a GI Symptom Tracker was created and validated in the USA and translated and validated in Dutch. This questionnaire consists of four subscales: Eating Challenges, Stools, Adherence Challenges, and Abdominal Symptoms. The aim of this study was to investigate the relationship between GI symptoms, anxiety/depression, and health-related quality of life (HRQoL) in Dutch pwCF.

In this prospective, cross-sectional single-center pilot study, pwCF completed the Dutch GI Symptom Tracker, GAD-7 (anxiety), PHQ-9 (depression), and CFQ-R (HRQoL) from September 2021 to June 2022. Regression analyses were used to analyze the univariable associations between GI symptoms, anxiety/depression, and HRQoL.

A total of 51 pwCF were enrolled consecutively (n = 41 adults, 66% female, mean age (y) [range] = 32.7 [19-71] and n = 10 adolescents, 70% female, mean age (y) [range] = 14.2 [12-17]). Elevated levels of anxiety (scores ≥ 10 on GAD-7) were found in 17% of adults and 0% of adolescents. Elevated depression scores (≥ 10 on PHQ-9) were found in 9% of adults and 20% of adolescents. GI scales "Abdominal Symptoms" and "Stools" were significantly, positively associated with elevated symptoms of anxiety and depression. Most GI scales were associated with lower HRQoL.

This is the first study investigating the link between GI symptoms assessed by the Dutch GI Symptom Tracker and anxiety/depression and HRQoL in Dutch pwCF. More GI symptoms were associated with higher anxiety and depression scores and worse HRQoL. Additional research is needed to better understand how mental and physical health are linked in GI symptoms in CF.