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Long-term anorectal complications affected QOL of patients with IBD
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Perianal and anorectal problems associated with inflammatory bowel disease persisted over time and negatively affected patient quality of life, according to recent study data.
To study the long-term course of anorectal concerns in patients with inflammatory bowel disease (IBD) and perianal lesions, researchers from the Netherlands performed a single-center study of 43 patients with Crohn’s disease (CD) and 13 with ulcerative colitis (UC) who underwent anorectal function evaluation (AFE) between 1993 and 2000.
Among the 46 patients who were available for follow-up between 2010 and 2012, 65% returned surveys, including the Inflammatory Bowel Disease Quality of Life Questionnaire (IBDQ), the Perianal Disease Activity Index (PDAI) and the fecal incontinence grading scale (Vaizey). Thirty-five percent of patients also were interviewed by telephone, 17 of whom underwent anorectal manometry and anal endosonography.
After a median follow-up of 14 years, 54% of patients had persistent anorectal complaints that included soiling (n=13), fecal incontinence (n=7) and active fistula (n=5). At baseline 39% of patients had an active fistula compared with 11% at follow-up. The pooled mean IBDQ score was 178 with 37% of patients having a score lower than 170. Pooled Vaizey scores showed a mean of 7, and the mean PDAI score of patients who underwent follow-up AFE was 4.2.
“In 25% of patients, an abnormal anorectal function was found at baseline, which unfortunately persisted in the long run,” the researchers concluded, adding that “although perianal and anorectal problems are rarely life threatening,” they negatively impacted patients’ quality of life.
Disclosure: The researchers report no relevant financial disclosures.
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