The Impact of Ostomy on Quality of Life and Functional Status of Crohnʼs Disease Patients

Abstract

Background The potential need for an ostomy is a main concern for patients with inflammatory bowel disease. We performed this study to evaluate the impact of a long term ostomy (≥ 6 months duration) on the functional status and specific patient-reported outcomes (PRO) in a population of patients with Crohn’s disease (CD). Methods We performed a cross-sectional analysis within the CCFA Partners cohort Study. Bivariate analyses and logistic regression models were used to investigate associations between ostomy and various demographic, disease factors, and PROs for health related quality of life (HRQOL). Results A total of 402 CD patients with ostomy for a minimum duration of 6 months were compared to 4331 CD patients with no ostomy. Patients with ostomy were more likely to be in clinical remission compared to those without ostomy, 48.5% vs. 31.3%, respectively. Having an ostomy did not impact overall HRQOL and was not associated with anxiety, depression, sleep disturbances, or reduced sexual interest and satisfaction. However, the presence of ostomy was associated with reduced social role satisfaction in patients both with controlled and active disease. Additionally, in the subset of patients who did not achieve clinical remission, those with ostomy experienced greater pain interference (OR 1.63, 95% CI 1.12–2.35) and fatigue (OR 1.66 95% CI 1.15–2.39). Conclusion Ostomy is well-tolerated in CD patients, particularly when clinical remission is achieved.

Depression and resilience in ulcerative colitis and Crohn's disease patients with ostomy

“…The depression degree in CD patients with ostomy showed statistically significant differences depending on marital status, monthly household income, length of sleep, and sleep disorder. This supports results from previous studies reporting marital and financial status as depression factors in CD patients . CD patients were almost younger than UC patients, and therefore, half the number of participants (32 patients, 50%) responded that they have a job and are in a phase of life wherein vigorous economic activity is required.…”

“…A Canadian study on the depression degree of IBD patients showed that poor health condition and poor nutrition were also significant influence factors of depresion . However, Abdalla and colleague observed significant associations between ostomy status and both fatigue amongst patients with clinically active disease but not for those in clinical remission to CD patients . Therefore, we suggest that further studies need to identify association between having an ostomy, fatigue, and depression in UC and CD patients with ostomy.…”

“…Despite the recent advances in medical treatments for ulcerative colitis (UC) and Crohn's disease (CD), UC and CD patients continue to require high surgical interventions . The incidence and prevalence of UC and CD in Korea are still lower than those in Western countries, but have been rapidly increasing during the past few decades.…”

“…Despite the recent advances in medical treatments for ulcerative colitis (UC) and Crohn's disease (CD), UC and CD patients continue to require high surgical interventions. [1][2][3][4] The incidence and prevalence of UC and CD in Korea are still lower than those in Western countries, but have been rapidly increasing during the past few decades. The result of the recent Korea nationwide population-based study has shown that the mean annual incidence for UC was 4.6 per 10 5 and for CD was 3.2 per 10 5 inhabitants, respectively, in 2006-2012.…”

Pouch-Related Symptoms and Quality of Life in Patients with Ileal Pouch–Anal Anastomosis

“…Among generally healthy populations, the mean T-score for pain interference, depression, anxiety, satisfaction with one’s social role, fatigue, and sleep disturbance is 50 with a standard deviation (SD) of 10. Based on prior studies evaluating the PROMIS measures in patients with IBD and other chronic conditions such as rheumatoid arthritis, 25,29–32 a minimally important difference of 2 was assigned when analyzing PROMIS measures.…”