Quality of life in inflammatory bowel disease in remission: the impact of IBS-like symptoms and associated psychological factors

Am J Gastroenterol. 2002 Feb;97(2):389-96. doi: 10.1111/j.1572-0241.2002.05475.x.


Objectives: Quality of life is reduced in inflammatory bowel disease (IBD). Whether or not this is true in IBD patients in long-standing remission is unclear. Symptoms compatible with irritable bowel syndrome (IBS) are common in IBD patients in remission. The importance of psychological factors in this process is a matter of controversy.

Methods: Forty-three patients with ulcerative colitis (UC) and 40 with Crohn's disease (CD), who had been in remission for at least 1 yr according to laboratory parameters and clinical and endoscopical appearance, were included. These patients completed four different self-administered questionnaires, evaluating GI symptoms, anxiety, depression, and psychological general well-being. The two patient groups were compared with the general population, and within-group comparisons in psychometric scores were made between patients with and without IBS-like symptoms.

Results: The psychological well-being in IBD patients in long-standing remission was similar to that of the general population, despite the presence of more severe GI symptoms. CD patients reported more psychosocial dysfunction, reduced well-being, and GI symptoms than UC patients. Thirty-three percent of UC patients and 57% of CD patients had IBS-like symptoms. The group with IBS-like symptoms (both UC and CD) had higher levels of anxiety and depression and more reduced well-being than those without. Anxiety and reduced vitality were found to be independent predictors for IBS-like symptoms in these patients.

Conclusion: The prevalence of IBS-like symptoms in IBD patients in long-standing remission is two to three times higher than that in the normal population. Psychological factors seem to be of importance in this process. However, as a group IBD patients in remission demonstrate psychological well-being comparable to that of the general population.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adaptation, Psychological
  • Adult
  • Anxiety / epidemiology
  • Cohort Studies
  • Colitis, Ulcerative / diagnosis
  • Colitis, Ulcerative / psychology*
  • Colitis, Ulcerative / therapy
  • Crohn Disease / diagnosis
  • Crohn Disease / psychology*
  • Crohn Disease / therapy
  • Depressive Disorder / epidemiology
  • Female
  • Humans
  • Male
  • Middle Aged
  • Probability
  • Quality of Life*
  • Remission, Spontaneous
  • Risk Assessment
  • Severity of Illness Index
  • Sickness Impact Profile
  • Statistics, Nonparametric
  • Sweden