Mucosal healing restores normal health and quality of life in patients with inflammatory bowel disease

Eur J Gastroenterol Hepatol. 2012 Jul;24(7):762-9. doi: 10.1097/MEG.0b013e32835414b2.


Background: Inflammatory bowel disease (IBD) is a debilitating immune disorder that impairs function and health-related quality of life (HRQOL). A goal of IBD treatment is mucosal healing, but it is not known whether it achieves normalization of the patients' perception of health. This can be assessed by using a cut-off scoring threshold of the Inflammatory Bowel Disease Questonnaire-36 (IBDQ-36).

Aims: To determine whether patients with Crohn's disease (CD) and ulcerative colitis (UC) in clinical remission and with mucosal healing normalize their HRQOL.

Methods: This is a multicentric, prospective, observational, cross-sectional study of patients who are in stable clinical remission and having mucosal healing. Patients completed the IBDQ-36, the EuroQol-5D, and the Daily Fatigue Impact Scale fatigue questionnaires. Complete restoration of health was believed to have occurred when the global score in the IBDQ-36 was at least 209 points.

Results: A total of 115 patients (48 with CD, 67 with UC) were included. The median activity index (the Harvey-Bradshaw or the colitis activity index) was 1.0 and the median endoscopic index (Simple Endoscopic Score for Crohn's disease or Mayo) was 0. Eighty percent of the patients (79% in CD and 82% in UC patients, P=NS) normalized their HRQOL. Type of treatment was not related to normalization of HRQOL. The lack of restoration of health was significantly related to fatigue and anxiety/depression.

Conclusion: Mucosal healing is associated with a normalization of the perception of health by most IBD patients independently of treatment. However, a significant group of patients do not achieve restoration of HRQOL, which reinforces the necessity of a global care addressed to all patient concerns to achieve patients' complete health restoration.

Publication types

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

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Anxiety / etiology
  • Colonoscopy
  • Depression / etiology
  • Fatigue / etiology
  • Female
  • Humans
  • Inflammatory Bowel Diseases / complications
  • Inflammatory Bowel Diseases / physiopathology
  • Inflammatory Bowel Diseases / rehabilitation*
  • Intestinal Mucosa / physiology*
  • Male
  • Middle Aged
  • Prospective Studies
  • Psychometrics
  • Quality of Life*
  • Regeneration / physiology*
  • Remission Induction
  • Severity of Illness Index
  • Young Adult