Impact of musculoskeletal joint complaints on quality of life in patients with inflammatory bowel disease: a cross-sectional study

Background Musculoskeletal joint complaints (MSCs) are the most common extraintestinal manifestation of inflammatory bowel disease (IBD). We aimed to investigate the effect of MSC on the health-related quality of life (QoL) in patients with IBD.Design A survey-based cross-sectional study among adult Dutch IBD patients.Setting Primary care, secondary care and patient association.Participants In total, 635 IBD patients were included. The mean age was 46.3 (SD 14.2) years, and 35% were male.Outcome MSC was defined as suffering from any joint complaints. QoL was measured using the IBD questionnaire and a 36-item short form health survey questionnaire.Methods A univariate analysis was performed to estimate the impact of various factors, such as demographic characteristics, setting, type of IBD and fatigue, which was followed by a multiple regression analysis to adjust for the confounding factors.Results Of the 635 IBD patients, 332 suffered from Crohn's disease (CD) and 303 from ulcerative colitis (UC). After adjusting for confounding factors, MSC was independently associated with reduced QoL among IBD patients (beta=-10.6, 95% CI -15.2 to -6.1), both in CD (beta=-8.3, 95% CI -14.6 to -2.1) and UC (beta=-13.9, 95% CI -20.5 to -7.3). 11% of the IBD patients had a rheumatological diagnosis. QoL in these patients was significantly lower compared with IBD patients with non-rheumatological MSC.Conclusions IBD patients with MSC are associated with a lower QoL, explicitly in patients with a rheumatological diagnosis. Prospective research is necessary to evaluate the causality and suitable interventions to increase QoL in these multimorbid patients.