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Effect of surgery on health-related quality of life in patients with inflammatory bowel disease: a prospective study.

BACKGROUND
Health-related quality of life (HRQL) has increasingly become a factor in management decisions in patients with chronic diseases.


OBJECTIVE
To measure the effect of surgical resection on quality of life in patients with inflammatory bowel disease (IBD).


DESIGN
A consecutive series of patients undergoing surgery for IBD between June 1994 and December 1997 were prospectively investigated as a cohort outcomes study.


PATIENTS
Data were obtained in 63 patients. The primary diagnoses were Crohn's disease (n = 36) and ulcerative colitis (n = 27).


INTERVENTION
Patients with Crohn's disease underwent resection with or without stricturoplasty for intractable disease; all but 3 patients with ulcerative colitis underwent ileoanal anastomoses with ileoanal reservoir.


MAIN OUTCOME MEASURE
Health status was measured using the Health Status Questionnaire preoperatively and every 3 months postoperatively.


RESULTS
Preoperative measures of HRQL of the patients were low, with values well below the general population in all 8 scales of the Health Status Questionnaire. Postoperatively, HRQL measures improved significantly (P < .05) in both patients with Crohn's disease and those with ulcerative colitis, with scores equal to the general population in most scales. For example, average raw scores for general health in previously studied patient groups were 59 in patients with asthma, 55 in those with diabetes mellitus, 74 in the general population, and 54 and 73 preoperatively and postoperatively, respectively, in the present study.


CONCLUSIONS
The results of this study confirm that HRQL scores are low in many patients with IBD referred for operation and HRQL scores improve postoperatively to levels comparable to those of the general population. We believe these data justify early surgical intervention in many patients with symptomatic IBD.