Medically reviewed by Onikepe Adegbola, MD, PhD
Patients with inflammatory bowel disease (IBD) often experience unpredictability in their condition, which can adversely affect their quality of life (QoL). Despite having a better QoL than patients with active disease, patients in remission have a lower QoL than healthy individuals.
Using a tertiary IBD center in Romania, a study sought to identify factors associated with a lower quality of life in patients with IBD in clinical remission. The study on Health-Related QoL in IBD Patients was published in the Journal of Medicine.
A clinical remission occurs when the symptoms of IBD have diminished to the point that they are mostly absent. Crohn’s disease is one of the most commonly occurring conditions of IBD. When you are in remission from Crohn’s disease, the disease is no longer active. It means that your immune system is functioning properly, and inflammation does not cause painful damage to your bowels or colon. During remission, you might notice that the pain has stopped, with no diarrhea or no fatigue. Moreover, the blood tests will show normal levels of inflammation.
Study Design for Clinical Remission
The study enrolled 97 adult patients with IBD who had been in clinical remission for at least 3 months. The study excluded pregnant women, patients with ostomies, perianal diseases, extraintestinal manifestations, and patients with other significant comorbidities.
63.9% of the 97 patients were male. They used the SCCAI score for ulcerative colitis and HBI score to assess the activity of Crohn’s disease at the end of the study.
Both ulcerative colitis and Crohn’s disease usually show similar symptoms, such as diarrhea, abdominal pain, fatigue, weight loss, etc.
The Simple Clinical Colitis Activity Index (SCCAI) is a score to validate the complicated disease activity. A score of fewer than 2.5 points indicates remission by the patient.
Alternatively, using the Harvey-Bradshaw Index (HBI), one can stratify Crohn’s disease severity.
Outcome of the Study
Researchers found an SCCAI score of less than 2.5 in ulcerative colitis and an HBI score of less than 4 in the case of Crohn’s disease.
Similarly, they evaluated the fatigue and anxiety levels of each patient. The researchers found 65 patients with CD and 32 with UC, most of whom were on biological therapy. About 33% of patients showed signs of anxiety and 16.5% of patients displayed signs of depression.
The analysis found that exposure to more than one biological therapy, fatigue, and symptoms of anxiety all contributed to a lower HR-QoL. This study clearly showed that patients with IBD in clinical remission have lower HR-QoL due to exposure to a greater number of biological agents, and anxiety.
In future studies, it should be evaluated whether early identification and prompt treatment could improve HR-QoL in IBD patients. Since the treatments for inflammatory bowel disease have certain limitations, further research in this area can lead to advancements in understanding the condition.
Stroie, T., Preda, C., Meianu, C., Croitoru, A., Gheorghe, L., Gheorghe, C., & Diculescu, M. (2022). Health-Related Quality of Life in Patients with Inflammatory Bowel Disease in Clinical Remission: What Should We Look For?. Medicina (Kaunas, Lithuania), 58(4), 486. https://doi.org/10.3390/medicina58040486