Effect of Intestinal Resection on Quality of Life in Crohn's Disease

Emily Wright, Michael Kamm, Peter De Cruz, Amy Hamilton, Kathryn Ritchie, Efrosinia Krejany, Alexandra Gorelik, Danny Liew, Lani Prideaux, Ian Lawrance, Jane Andrews, Peter Bampton, Miles Sparrow, Timothy Florin, Peter Gibson, Henry Debinski, Richard Gearry, Finlay Macrae, Rupert Leong, Ian KronborgGraham Radford-Smith, Warwick Selby, Michael Johnston, Rodney Woods, P Elliott, Sally Bell, Steven Brown, William Connell, Paul Desmond

Research output: Contribution to journalArticlepeer-review

18 Citations (Scopus)

Abstract

Introduction: Patients with Crohn's disease have poorer health-related quality of life [HRQoL] than healthy individuals, even when in remission. Although HRQoL improves in patients who achieve drug-induced or surgically induced remission, the effects of surgery overall have not been well characterised. Methods: In a randomised trial, patients undergoing intestinal resection of all macroscopically diseased bowel were treated with postoperative drug therapy to prevent disease recurrence. All patients were followed prospectively for 18 months. C-reactive protein [CRP], Crohn's Disease Activity Index [CDAI], and faecal calprotectin [FC] were measured preoperatively and at 6, 12, and 18 months. HRQoL was assessed with a general [SF36] and disease-specific [IBDQ] questionnaires at the same time points. Results: A total of 174 patients were included. HRQoL was poor preoperatively but improved significantly [p < 0.001] at 6 months postoperatively. This improvement was sustained at 18 months. Females and smokers had a poorer HRQoL when compared with males and non-smokers, respectively. Persistent endoscopic remission, intensification of drug treatment at 6 months, and anti-tumour necrosis factor therapy were not associated with HRQoL outcomes different from those when these factors were not present. There was a significant inverse correlation between CDAI, [but not endoscopic recurrence, CRP, or FC] on HRQoL. Conclusion: Intestinal resection of all macroscopic Crohn's disease in patients treated with postoperative prophylactic drug therapy is associated with significant and sustained improvement in HRQoL irrespective of type of drug treatment or endoscopic recurrence. HRQoL is lower in female patients and smokers. A higher CDAI, but not direct measures of active disease or type of drug therapy, is associated with a lower HRQoL. Copyright

Original languageEnglish
Pages (from-to)452-462
Number of pages11
JournalJournal of Crohns & Colitis
Volume9
Issue number6
DOIs
Publication statusPublished - 1 Jun 2015

Keywords

  • biologicals
  • Crohn's disease
  • health-related quality of life
  • inflammatory bowel disease
  • postoperative
  • smoking

Fingerprint Dive into the research topics of 'Effect of Intestinal Resection on Quality of Life in Crohn's Disease'. Together they form a unique fingerprint.

Cite this