Effect of ulcerative colitis severity and proctocolectomy on patient-reported outcomes

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Created On: 20/09/2023

A cross-sectional study was conducted to examine the effects of both the severity of symptoms in ulcerative colitis and proctocolectomy on nine outcomes as reported by patients.

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Key take away

Ulcerative colitis is linked with reduced work productivity, mood, fatigue, and quality of life, even in people with mild symptoms. Also, patients who undergo proctocolectomy show worse scores than patients in remission.

Background

A cross-sectional study was conducted to examine the effects of both the severity of symptoms in ulcerative colitis and proctocolectomy on nine outcomes as reported by patients.

Method

Consecutively, subjects under tertiary care in medical institutions were recruited in the YOu and Ulcerative colitis: Registry and Social network (YOURS) registry. These individuals finished validated questionnaires concerning their lifestyle, symptoms associated with the disease, and psychosocial elements.

The symptom severity was determined through self-graded stool frequency and rectal bleeding scores (categorized as remission, active disease [severe, moderate, mild]). By comparing standardized mean differences of patient-reported outcome scores, an evaluation of the impact of proctocolectomy or symptom severity on 9 scales for sleep, work productivity, depression/anxiety, fatigue, and quality of life was done.

Result

Out of the 1971 survey responses that were examined, 2.1% (n=42) had undergone proctocolectomy, 29.6% (n=583) were dealing with active disease, and 68.3% (n=1346) volunteers were experiencing remission. An observable linear correlation was noted between escalating symptom severity and deteriorating quality of life, increased fatigue, heightened anxiety, amplified depression, and reduced work productivity.

Notably, even patients having mild symptoms had scores indicating a worse condition compared to those in remission. Additionally, individuals who had undergone proctocolectomy also exhibited lower scores than those in remission.

Conclusion

Even mild symptoms of ulcerative colitis are related to a decrease in mood, quality of life, fatigue, and work productivity, indicating the potential for improved patient-reported outcomes through active management, regardless of illness severity.