According to findings recently published in the Scandinavian Journal of Gastroenterology, two different clinical scoring systems should be used to evaluate gastrointestinal problems in systemic mastocytosis (SM): the Gastrointestinal Rating Scale (GSRS) should be used for physical gastrointestinal symptoms, and the Visceral Sensitivity Index (VSI) for gastrointestinal-related worries and psychosocial concerns.
People with SM who experience gastrointestinal symptoms often find them to be unpredictable, with considerable consequences on quality of life. However, when assessing the intestinal mucosa macroscopically, doctors often find that it appears normal. Only microscopic evaluations reveal an unusually higher number of mast cells.
Doctors today need to have objective instruments to assess gastrointestinal symptoms associated with SM. Some of these are already in existence.
The study’s authors hence sought to investigate the use of these instruments in quantifying real-world symptoms and patient concerns. This study was split into multiple phases.
The first involved the analysis of qualitative interviews involving 16 patients with SM conducted by one of the study’s authors. In addition, researchers looked through the evidence present in existing studies to gauge physical symptoms and psychological concerns.
The second phase involved searching for instruments that are used for patient assessments in irritable bowel syndrome, a condition with many gastrointestinal symptoms similar to SM. The research team selected a number of clinical scoring tools to assess both physical signs and symptoms, as well as psychosocial consequences and worries. The research team sifted down the clinical instruments to the GSRS and the VSI.
Read more about SM testing and diagnosis
The third phase of the study involved assessing the relevance of the the GSRS and the VSI in a small group of patients with SM-related gastrointestinal symptoms. Phase four involved testing these tools in a larger population of patients.
Researchers concluded that the GSRS and the VSI were the “most appropriate instruments” for measuring disease parameters in SM. “Based on our results, we propose the use of the GSRS for measuring physical [gastrointestinal] problems in the SM population, for both clinical and research purposes,” the authors of the study concluded.
The study’s authors found that the GSRS — which focuses on recent symptoms — was best for measuring the clinical aspects of gastrointestinal symptoms. The VSI, on the other hand, helped shine a light on problems that were not otherwise apparent to doctors, but was not as useful for evaluating clinical changes over time.
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