Gracie, DJ orcid.org/0000-0001-9616-981X, Hamlin, PJ and Ford, AC orcid.org/0000-0001-6371-4359 (2018) Longitudinal impact of IBS-type symptoms on disease activity, healthcare utilization, psychological health, and quality of life in inflammatory bowel disease. American Journal of Gastroenterology, 113. pp. 702-712. ISSN 0002-9270
Abstract
OBJECTIVES: The impact of irritable bowel syndrome (IBS)-type symptoms on the natural history of inflammatory bowel disease (IBD) is uncertain. We aimed to address this in a longitudinal study of secondary care patients. METHODS: Longitudinal disease activity was defined by disease flare, escalation of medical therapy, hospitalization, or intestinal resection. The number of investigations performed and clinics attended determined healthcare utilization. Psychological well-being and quality of life were assessed using validated questionnaires. These outcomes were compared over a minimum period of 2 years between patients reporting IBS-type symptoms and patients with quiescent disease, occult inflammation, and active disease at baseline. RESULTS: In 360 IBD patients, there were no differences in longitudinal disease activity between patients with IBS-type symptoms and patients with quiescent disease or occult inflammation. Disease flare and escalation of medical therapy was more common in patients with active disease than in patients with IBS-type symptoms (hazard ratio (HR) = 3.16; 95% confidence interval (CI) 1.93–5.19 and HR = 3.24; 95% CI 1.98–5.31, respectively). A greater number of investigations were performed in patients with IBS-type symptoms than quiescent disease (P = 0.008), but not compared with patients with occult inflammation or active disease. Anxiety, depression, and somatization scores at follow up were higher, and quality-of-life scores lower, in patients with IBS-type symptoms when compared with patients with quiescent disease, but were similar to patients with active disease. CONCLUSIONS: IBS-type symptoms in IBD were associated with increased healthcare utilization, psychological comorbidity, reduced quality of life, but not adverse disease activity outcomes during extended follow-up.
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Copyright, Publisher and Additional Information: | © 2018 The American College of Gastroenterology. This is an author produced version of a paper published in American Journal of Gastroenterology. Uploaded in accordance with the publisher's self-archiving policy. | ||||||
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Institution: | The University of Leeds | ||||||
Academic Units: | The University of Leeds > Faculty of Medicine and Health (Leeds) > Institute of Molecular Medicine (LIMM) (Leeds) > Section of Molecular Gastroenterology (Leeds) | ||||||
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Depositing User: | Symplectic Publications | ||||||
Date Deposited: | 23 Apr 2018 10:40 | ||||||
Last Modified: | 16 Aug 2018 00:38 | ||||||
Status: | Published | ||||||
Publisher: | Nature Publishing Group | ||||||
Identification Number: | https://doi.org/10.1038/s41395-018-0021-z |