Changes in General Health (GHQ-28) Scores before and Two Months after Colonoscopy among Patients with Lower Gastrointestinal Diseases

Abstract

Background: Lower gastrointestinal disorders are among the most common chronic conditions and may affect both physical and psychological aspects of health. Previous evidence suggests that psychological factors, including anxiety, depression, and stress, play an important role in the onset, persistence, and exacerbation of gastrointestinal symptoms. In addition, diagnostic procedures such as colonoscopy and awareness of disease status may influence patients’ overall health. This study aims to evaluate the general health status of patients with lower gastrointestinal diseases before and two months after colonoscopy.

Methods: This was a single-group before-and-after observational study conducted on 135 patients with lower gastrointestinal diseases who attended Imam Ali Clinic in Shahrekord, Iran, in 2020. Participants were selected using a convenience sampling method. Data were collected using the 28-item General Health Questionnaire (GHQ-28) before colonoscopy and again two months after the procedure. Then, data were analyzed using SPSS version 22. Descriptive statistics and inferential tests, including Kolmogorov–Smirnov, paired t-test, independent t-test, one-way ANOVA, and ANCOVA, were used. Finally, a p-value <0.05 was considered statistically significant.

Results: The mean age of participants was 47.38±12.05 years. The mean total GHQ score was 23.78±12 before colonoscopy and 24.34±13.94 two months later. No statistically significant difference was observed in the overall general health score before and after colonoscopy (P=0.33). Likewise, no significant differences were found in the domains of physical symptoms, anxiety and insomnia, and social functioning. However, depression scores increased significantly two months after colonoscopy (P=0.01). Before colonoscopy, 49.6% of patients had poor general health status, compared with 41.5% two months later.

Conclusion: Colonoscopy did not significantly change overall GHQ-28 scores. However, because there was no control group, causal conclusions cannot be made. Although depressive symptoms increased significantly, the change was small, so its clinical importance should be interpreted cautiously.