Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Multicenter Study
. 2025 Aug 29;20(8):e0331092.
doi: 10.1371/journal.pone.0331092. eCollection 2025.

Lifestyle and psychosocial factors in inflammatory bowel disease: Prevalence, impact, motivation, and support needs

Karlijn Demers  1   2   3 , Evelien M B Hendrix  1   3 , Ashkan Rezazadeh Ardabili  1   3 , Quirine M Bredero  4 , Ad A van Bodegraven  1   3   5 , Daniëlle van der Horst  6 , Daisy M A E Jonkers  1   3 , Merel L Kimman  7   8 , Zlatan Mujagic  1   3 , Mariëlle J Romberg-Camps  5 , Tessa E H Römkens  9 , Menne P Scherpenzeel  6 , Maya J Schroevers  4 , Laurents P S Stassen  2   3 , Rachel L West  10 , Gerard Dijkstra  11 , Marieke J Pierik  1   3
Affiliations
Multicenter Study

Lifestyle and psychosocial factors in inflammatory bowel disease: Prevalence, impact, motivation, and support needs

Karlijn Demers et al. PLoS One. .

Abstract

Background and aim: Lifestyle and psychosocial factors impact mucosal inflammation and well-being of Inflammatory Bowel Disease (IBD) patients. However, lifestyle assessment and interventions are not standard care. The aim of this study was to estimate the occurrence of and gather patients' perspectives on unfavorable lifestyle and psychosocial factors in individuals with IBD.

Methods: A multicenter study was conducted, enrolling IBD patients using a telemedicine platform that reports on disease activity, lifestyle, and psychosocial factors. Patients' perspectives were gathered through a nationwide online survey distributed by the Dutch IBD patient organization.

Results: In the telemedicine cohort (n = 460), 16.3% followed a specific diet, and 50.7% believed diet impacted their disease or quality of life. Additionally, 67.4% did not meet exercise norms, 9.3% smoked, and 8.0% had excessive alcohol consumption (>7 units/week). About one-third experienced high stress, poor sleep regularly, and emotional distress occasionally. In the nationwide survey (n = 1126), most patients (58-91%) believed that stress, unhealthy diet, poor sleep, physical inactivity, and anxiety or depression could cause intestinal symptoms. Around 70% were motivated to change diet, stress management, and physical activity. Less than one-fifth of patients received hospital support, with the majority being satisfied. Approximately 20% of patients desired but lacked support concerning stress, physical activity, diet, and sleep.

Conclusions: Patients with IBD commonly report unfavorable lifestyle and psychosocial factors, recognize their impact on intestinal symptoms, and are motivated to change, but often lack hospital support. This underscores the importance for systematic incorporation of lifestyle and psychosocial factors into patient-centered IBD care and the potential for targeted interventions.

PubMed Disclaimer

Conflict of interest statement

I have read the journal's policy and the authors of this manuscript have the following competing interests. K. Demers, E.M.B. Hendrix, Q.M. Bredero, D. van der Horst, M.L. Kimman, M.J. Romberg-Camps, and M.J. Schroevers report no conflicts of interest. A. Rezazadeh Ardabili reports speaker fees from Lilly, AbbVie, and Galapagos, all outside the submitted work. A.A. van Bodegraven has served as speaker, adviser and/or principal investigator for AbbVie, AlfaSigma, Arena, BMS, Cablon, Celltrion, Ferring, Galapagos, Janssen, Lilly, Pfizer, Roche, and TEVA, and received research grants from TEVA and Pfizer, all outside the submitted work. D.M.A.E. Jonkers reports grant from the public-private partnership grants of Dutch Top Institute of Food and Nutrition (TIFN), Top Knowledge Institute (TKI) Agri&Food and Health Holland, by the Carbokinetics program as part of the NWO-CCC Partnership Program, by Organic A2BV/Mothersfinest BV and, EU/FP7 SysmedIBD/305564, BIOM/305479 and Character/305676, H2020 DISCOvERIE/848228, all outside the submitted work. Z. Mujagic reports grants form Niels Stensen Fellowship, MLDS, ZonMw, TKI and Galapagos, advisory board fees from Johnson & Johnson, Lilly, Pfizer (paid to host institution), and received speaker’s fees from Galapagos and Takeda (paid to host institution), all outside the submitted work. T.E.H. Römkens served as speaker or consultant for Ferring, Janssen, and Takeda, all outside the submitted work. M.P. Scherpenzeel served on the patient advisory board of Janssen and Pfizer and received a speaker’s fee from Abbvie for participating in a webinar, all on behalf of Crohn & Colitis NL and outside the submitted work. L.P.S. Stassen serves on the advisory board of Diagnostic Green Gmbh and has served as a speaker and received research support from Takeda, all outside the submitted work. R.L. West served on the advisory board and as an invited speaker for Janssen, Pfizer, Takeda, and Galapagos, all outside the submitted work. G. Dijkstra received grant support from Royal DSM, served as a consultant for Astra-Zenica, and received a speaker’s fee from AbbVie, all outside the submitted work. M.J Pierik reports grants and non-financial support from Falk Pharma, grants from European commission, grants from ZonMw (Dutch national research fund), grants and non-financial support from Takeda, grants and non-financial support from Johnson and Johnson, grants and non-financial support from AbbVie, non-financial support from Ferring, non-financial support from Immunodiagnostics, non-financial support from MSD, all outside the submitted work.

Figures

Fig 1
Fig 1. Patients’ perspective on the impact of lifestyle and psychosocial factors on intestinal symptoms.
Fig 2
Fig 2. Current action or motivation to change lifestyle and psychosocial factors.
Fig 3
Fig 3. Thematic categorization of responses to the open-ended question ‘Could you give a description of actions already taken?’, presented per lifestyle or psychosocial factor.
Fig 4
Fig 4. Thematic categorization of responses to the open-ended question ‘What do you need that could help you make a change?’, presented per lifestyle or psychosocial factor.
Fig 5
Fig 5. Support received for lifestyle and psychosocial factors from healthcare professionals of the hospital and satisfaction with this support.
See this image and copyright information in PMC

References

    1. GBD 2017 Inflammatory Bowel Disease Collaborators. The global, regional, and national burden of inflammatory bowel disease in 195 countries and territories, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet Gastroenterol Hepatol. 2020;5(1):17–30. doi: 10.1016/S2468-1253(19)30333-4 - DOI - PMC - PubMed
    1. Day AS, Yao CK, Costello SP, Andrews JM, Bryant RV. Food avoidance, restrictive eating behaviour and association with quality of life in adults with inflammatory bowel disease: a systematic scoping review. Appetite. 2021;167:105650. doi: 10.1016/j.appet.2021.105650 - DOI - PubMed
    1. Fagan G, Osborne H, Schultz M. Physical activity in patients with inflammatory bowel disease: a cross-sectional study. Inflamm Intest Dis. 2021;6(2):61–9. doi: 10.1159/000511212 - DOI - PMC - PubMed
    1. Graff LA, Vincent N, Walker JR, Clara I, Carr R, Ediger J, et al. A population-based study of fatigue and sleep difficulties in inflammatory bowel disease. Inflamm Bowel Dis. 2011;17(9):1882–9. doi: 10.1002/ibd.21580 - DOI - PubMed
    1. Peppas S, Pansieri C, Piovani D, Danese S, Peyrin-Biroulet L, Tsantes AG. The brain-gut axis: psychological functioning and inflammatory bowel diseases. J Clin Med. 2021;10(3). - PMC - PubMed

Publication types

LinkOut - more resources