Quality of life after proctocolectomy and ileo-anal anastomosis for severe ulcerative colitis

Objective Impaired quality of life (QOL) in patients with ulcerative colitis (UC) may he a prominent feature of the disease, and ire some cases, may become an indication for surgical treatment. The objective of this study was to assess QOL in patients who underwent proctocolectomy with ilea-anal anastomosis with a J pouch Tof severe UC and to compare it with patients with CTC of different severity who were under medical treatment, Methods: We used a validated, disease-specific research instrument (a 29 item, seif-administered questionnaire) that examines the following four: four functions: intestinal (score 0-24) and systemic symptoms (0-21), and emotional (0-27) and Social Function (0-15), High scores indicate an impairment of the function examined and the sum of the four scores (maximal total score = 87) reflects the patient's QOL, We studied 29 operated patients (22 men, mean age 35 yr, mean time after intervention 3.8 yr) and compared their scores with those of 57 UC patients (39 men, mean age 36 yr) with different degrees of disease activity, and with those of 72 healthy controls (38 men, mean age 31 yr), Results: In UC, scores were significantly higher than in controls, increasing with the severity of the disease, Even patients in remission had higher scores than controls in the "systemic" (4.6 vs, 2.0) and emotional (5.6 vs, 2.5) functions, Patients who underwent surgical treatment had much better stores than patients with severe disease (total score 20.1 vs, 38.2), with values comparable to those of patients in remission or with mild disease activity. There was no significant gender difference, either for UC and ileo-anal anastomosis patients, or in healthy controls, Conclusion: Iir patients with UC, even in ri mission, there is a measurable impairment of QOL, which increases with the severity of disease, Operated patients have a QOL that is comparable to that of patients in remission or with mild disease, and proctocolectomy with ileo-anal anastomosis may restore an acceptable QOL, in patients with moderate/severe UC. (C) 1998 bg Am, Coll. of Gastroenterology).