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. 2010 Jul 7;16(25):3168-77.
doi: 10.3748/wjg.v16.i25.3168.

Impact of pain on health-related quality of life in patients with inflammatory bowel disease

Anja Schirbel  1 , Anne Reichert, Stephanie Roll, Daniel C Baumgart, Carsten Büning, Bianca Wittig, Bertram Wiedenmann, Axel Dignass, Andreas Sturm
Affiliations

Impact of pain on health-related quality of life in patients with inflammatory bowel disease

Anja Schirbel et al. World J Gastroenterol. .

Abstract

Aim: To evaluate intensity, localization and cofactors of pain in Crohn's disease and ulcerative colitis patients in connection with health-related quality of life (HRQOL) and disease activity.

Methods: We reviewed and analyzed the responses of 334 patients to a specifically designed questionnaire based on the short inflammatory bowel disease questionnaire (SIBDQ) and the German pain questionnaire. Pain intensity, HRQOL, Crohn's disease activity index (CDAI) and colitis activity index (CAI) were correlated and verified on a visual analog scale (VAS).

Results: 87.9% of patients reported pain. Females and males reported comparable pain intensities and HRQOL. Surgery reduced pain in both genders (P = 0.023), whereas HRQOL only improved in females. Interestingly, patients on analgesics reported more pain (P = 0.003) and lower HRQOL (P = 0.039) than patients not on analgesics. A significant correlation was found in UC patients between pain intensity and HRQOL (P = 0.023) and CAI (P = 0.027), and in CD patients between HRQOL and CDAI (P = 0.0001), but not between pain intensity and CDAI (P = 0.35). No correlation was found between patients with low CDAI scores and pain intensity.

Conclusion: Most IBD patients suffer from pain and have decreased HRQOL. Our study reinforces the need for effective individualized pain therapy in IBD patients.

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Figures

Figure 1
Figure 1
Distribution of pain in female and male patients. The degree of abdominal pain is quite similar in males and females, although females complain more often of arthralgia.
Figure 2
Figure 2
Differences in pain intensity (A) and health-related quality of life (HRQOL) (B) in Crohn’s disease (CD) and ulcerative colitis (UC) patients. CD and UC patients have similar pain levels and HRQOL scores. Compared to healthy controls IBD patients have decreased HRQOL (C).
Figure 3
Figure 3
Comparison of (A) pain intensity and (B) HRQOL in patients with and without analgesic treatment. Pain intensity is even higher in patients receiving analgesic treatment.
Figure 4
Figure 4
Distribution of disease activity index and pain intensity (A) and disease activity index and HRQOL (B) in UC patients and CD patients (C, D), respectively. UC patients with high disease activity have significantly higher pain levels and lower HRQOL. Although pain intensity does not correlate with CDAI, HRQOL correlates well with CDAI.
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