Quality of life of ulcerative colitis patients treated surgically with proctocolectomy and J-pouch formation: a comparative study before surgery and after closure of the defunctioning ileostomy

Georgios Exarchos; Antonios Gklavas; Linda Metaxa; Ioannis Papaconstantinou

Authors Georgios Exarchos, Antonios Gklavas, Linda Metaxa, Ioannis Papaconstantinou.

Abstract

Background Ulcerative colitis (UC) is a lifelong disease with a relapse-remission pattern that affects patients’ social and psychological wellbeing. Restorative proctocolectomy and J-pouch formation is the gold-standard surgical procedure in cases where symptoms are refractory to currently available medical treatment. The aim of this study was to assess patients’ quality of life (QoL) in order to evaluate the efficiency of surgery and patients’ symptomatology.

Methods We performed a prospective comparative study of the QoL of 47 patients with UC, treated surgically. As research tools, we used the Inflammatory Bowel Disease Questionnaire (IBDQ) and the Cleveland Global Quality of Life (CGQL) questionnaire. Parametric and nonparametric tests were used in order to correlate areas of QoL and other selected factors, such as marital status, sex, age, and education.

Results The mean scores before and after closure of the ileostomy were 153.29 and 178 for the IBDQ (P=0.0025), and 17.4 and 23.42 for the CGQL (P<0.001), suggesting an overall improvement in QoL. The research showed that there was no specific QoL factor, such as intestinal, systemic, emotional or social life symptoms, that improved significantly more than the others (P=0.99). The IBDQ showed that patients aged less than 20 years (P<0.001), female patients (P=0.03) and patients with secondary education (P<0.001) reported the greatest improvement.

Conclusions The QoL in UC patients treated surgically improved following closure of the defunctioning ileostomy. QoL studies are encouraged to optimize and maintain high standards of surgical care, and they could potentially be used for assessment of therapeutic efficacy.

Keywords Inflammatory bowel disease questionnaire, ulcerative colitis, Cleveland global quality of life questionnaire

Ann Gastroenterol 2018; 31 (3): 350-355