(06-05-12) Mucosal healing restores normal health and quality of life in patients with inflammatory bowel disease.

Casellas F, Barreiro de Acosta M, Iglesias M, Robles V, Nos P, Aguas M,
Riestra S, de Francisco R, Papo M, Borruel N.
Source
aCrohn-Colitis Care Unit (UACC), Networked Biomedical Research Center
(Ciberehd), Vall d'Hebron University Hospital, Barcelona bSantiago de
Compostela Clinic Hospital cLa Fe University Hospital, Valencia dAsturias
University Hospital, Oviedo eJoan XXIII Hospital, Tarragona, Spain.
Abstract
BACKGROUND:
Inflammatory bowel disease (IBD) is a debilitating immune disorder that
impairs function and health-related quality of life (HRQOL). A goal of IBD
treatment is mucosal healing, but it is not known whether it achieves
normalization of the patients' perception of health. This can be assessed by
using a cut-off scoring threshold of the Inflammatory Bowel Disease
Questonnaire-36 (IBDQ-36).
AIMS:
To determine whether patients with Crohn's disease (CD) and ulcerative colitis
(UC) in clinical remission and with mucosal healing normalize their HRQOL.
METHODS:
This is a multicentric, prospective, observational, cross-sectional study of
patients who are in stable clinical remission and having mucosal healing.
Patients completed the IBDQ-36, the EuroQol-5D, and the Daily Fatigue Impact
Scale fatigue questionnaires. Complete restoration of health was believed to
have occurred when the global score in the IBDQ-36 was at least 209 points.
RESULTS:
A total of 115 patients (48 with CD, 67 with UC) were included. The median
activity index (the Harvey-Bradshaw or the colitis activity index) was 1.0 and
the median endoscopic index (Simple Endoscopic Score for Crohn's disease or
Mayo) was 0. Eighty percent of the patients (79% in CD and 82% in UC patients,
P=NS) normalized their HRQOL. Type of treatment was not related to
normalization of HRQOL. The lack of restoration of health was significantly
related to fatigue and anxiety/depression.
CONCLUSION:
Mucosal healing is associated with a normalization of the perception of health
by most IBD patients independently of treatment. However, a significant group
of patients do not achieve restoration of HRQOL, which reinforces the necessity
of a global care addressed to all patient concerns to achieve patients'
complete health restoration.

Source: Eur J Gastroenterol Hepatol. 2012 Apr 17. [Epub ahead of print]

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