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PWE-025 Comparing quality of life in coeliac disease and inflammatory bowel disease: a paradigm shift in our perceptions?

Introduction The Medical Outcomes Study Short-Form 36-Item Health Survey (SF-36) is a valid and reliable quality of life (QoL) measure in coeliac disease and inflammatory bowel disease (IBD). However, there has never been a study to compare the QoL of individuals with these two diseases. We hypothesised that individuals with IBD report a worse QoL than those individuals with coeliac disease because IBD is considered to be the more severe disease of the two.1 Methods A postal survey (n=1031) of patients with histologically proven Coeliac Disease (n=225), Crohn's disease (CD) (n=230) and ulcerative colitis (UC) (n=228). We also recruited non-health-seeking age and sex matched controls (n=348). Questionnaire included SF-36, Hospital Anxiety and Depression Scale (HADS), ROME II criteria for Irritable Bowel Syndrome (IBS) and a reflux oesophagitis (RO) screen. Disease-specific assessment included disease duration and either the Harvey-Bradshaw Activity Index (HBI), Simple Colitis Activity Index (SCAI) or assessment of gluten-free diet (GFD) adherence. Result Disease duration had a negligible impact on responses in CD, UC and Coeliac Disease (p=ns). At least one RO symptom was reported by 66% of Coeliac Disease respondents, 72% of CD, 62% of UC and 50% of controls. We found stepwise reductions in all respondents' SF-36 scores and increases in HADS-A and HADS-D scores with increasing RO symptom severity (p=<0.05). 22% of Coeliac Disease respondents, 24% of CD, 16% of UC and 6% of controls met ROME II criteria for IBS, which also reduced respondent wellbeing in all groups (p=<0.0001) (Abstract 025). Abstract PWE-025 Overall group comparison of SF-36 and HADS scores Crohn's disease Ulcerative colitis Coeliac diease Controls p Value SF-36 PCS (Median) 43.09 49.19 46.99 53.40 <0.0001 SF-36 MCS (Median) 42.90 50.65 46.10 50.77 <0.0001 HADS-A (Median) 8.0 6.0 7.3 5.3 <0.0001 HADS-D (Median) 9.0 7.0 7.5 5.5 <0.0001 Conclusion This is the first study to report that CD patients experience the worst QoL but surprisingly Coeliac Disease patients had a worse QoL and increased risk of anxiety and depression than UC (p=<0.0001). In addition we observed that both RO and IBS further reduce patient QoL and increase the risk of anxiety and depression.