Health-related quality of life in patients with inflammatory bowel disease: a single-center experience

Maria Kalafateli; Christos Triantos; Georgios Theocharis; Dimitra Giannakopoulou; Efstratios Koutroubakis; Aristidis Chronis; Apostolos Sapountzis; Vasileios Margaritis; Konstantinos Thomopoulos; Vasiliki Nikolopoulou

Authors Maria Kalafateli, Christos Triantos, Georgios Theocharis, Dimitra Giannakopoulou, Efstratios Koutroubakis, Aristidis Chronis, Apostolos Sapountzis, Vasileios Margaritis, Konstantinos Thomopoulos, Vasiliki Nikolopoulou.

Abstract

Background Inflammatory bowel disease (IBD) has a negative impact on health-related quality of life (HRQoL). The aim of the study was to assess HRQoL of IBD patients in South-Western Greece.

Methods 89 IBD patients [38 (42.7%) Crohn's disease (CD), 51 (57.3%) ulcerative colitis (UC)] were included. HRQoL was assessed using IBD questionnaire (IBDQ), which tests four health domains: bowel symptoms (BS), systemic symptoms (SS), emotional function (EF) and social function (SF). Total score (TS) ranges from 32 to 224. Disease activity was measured using Crohn's Disease Activity Index (CDAI) (CD), and Truelove and Witts classification (UC). The impact of epidemiological and disease-specific characteristics on IBDQ was studied.

Results No statistically significant difference was found in all IBDQ scores between UC and CD patients. No correlation was found regarding age, sex, smoking, anemia, disease duration and use of corticosteroids, 5-aminosalicylates or immunosuppressives with HRQoL. The factors found to have a major negative impact on all IBDQ scores was disease severity both in CD and UC, and education on bowel symptoms in CD. On multivariate analysis, only high disease activity had significant effects on total and dimensional scores of IBDQ in UC (TS, P=0.005; BS, P<0.001; SS, P=0.004; EF, P=0.05; SF, P=0.001), whereas in CD, only CDAI (TS, P=0.001; BS, P=0.004; SS, P=0.001; EF, P=0.003; SF, P=0.003) and education (TS, P=0.047; BS, P=0.004; SS, P=0.03) had significant effects.

Conclusions IBD patients in remission experience better HRQoL than patients with active disease. Induction of remission should become the mainstay of care regarding improvement in HRQoL.

Keywords Inflammatory bowel diseases, quality of life, Crohn's disease, ulcerative colitis