11. tbl. 102. árg. 2016

Quality of Life after colectomy due to ulcerative colitis

Lífsgæði eftir ristilbrottnám vegna sáraristilbólgu

Introduction: A significant proportion of patients with ulcerative colitis (UC) undergo colectomy. The aim was to assess the quality of life (QOL) of these patients.

Material and methods: All patients with UC who underwent colectomy at The National University Hospital of Iceland or Akureyri Hospital 1995-2009 were included. 106 patients received three questionnaires. SF-36v2 and EORTC are standardised QOL-questionnaires. The third contained functional questions designed by the researchers.

Results: Eighty-three patients replied (78%), 45 men (54%) and 38 women (46%). Average age at operation was 45 years (10-91 years). Forty-four (53%) had ileostomy, 28 (34%) ileal pouch-anal anastomosis (IPAA) and 11 (13%) ileorectal anastomosis. Among patients who had the rectum removed 37% described changes in urinary habits and 46% in sexual life after surgery.  Among patients with IPAA 75% admitted to faecal incontinence but this was mild according to Wexner‘s scale in 83% of the cases. According to SF-36v2 there was no significant difference in the QOL of colectomy patients compared to the general population. Patients generally felt good about their health, body image and weight and had mild symptoms according to EORTC QLQ-CR29.

Conclusions: Urinary habits and sexual life were commonly affected after rectal removal. Faecal incontinence among IPAA-patients was much more common than expected. There was not much difference in quality of life compared to the general population. The results of the study are important for patient education and may aid them in their decision making since removing the colon or having a stoma does not seem to affect quality of life.

 

Figure 1: Patients who received questionnaires.

Figure 2: The chart shows the number of bowel movements among patients with IPAA during the day (pale blue) and night (purple). The majority of the responders  had 0-1 bowel motion during the night while all responders had at least 4 bowel movements during day
IPAA = Ileal pouch-anal anastomosis

Figure 3: The red line signifies the average score of the US general population (50, standard deviation 10). The first two columns on the left represent the physical (blue) and mental (grey) component summaries. The remaining columns to the right represent the sub components of the questionnaire relating to physical (blue)  and mental (grey) quality of life. The Physical Component Summary  among the patients was on average 46,64 (1 SD = 11,25)  compared to 50 (1 SD =10) among the US general population. The Mental Component Summary among the patients was 47,28 (1 SD = 11,15) compared to 50 (1 SD = 10) among the US general population.
SF-36v2 = Short Form (36) Health Survey

Figure 4: Results according to gender. Women rate their physical quality of life (first column) lower than men (42,39 vs 49,95). However the difference is less than 1 SD.
SF-36v2 = Short Form (36) Health Survey; M = Male; F = Female

Figure 5: SF-36v2 results according to type of operation. There is no statistically significant difference in QOL between the groups.
-36v2 =
Short Form (36) Health Survey

 

Table 1: The table displays the average age of the patients at the time of operation and at the time of research (2011).

Table 2: EORTC results (median (interquartile range)).

 

Table 3: EORTC results according to age group.

 

 









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