Impact of pain on health-related quality of life in patients with inflammatory bowel disease

Table 1 Demographic data of IBD patients and healthy controls, separated into CD and UC groups

Demographics	CD	UC
Total	179	155
Age, mean, (SD), [range], yr	38.9 (± 11.6) [18-71.6]	39.8 (± 13.7) [18.6-75.5]
Age at disease onset, mean, (median), [interquartile range], yr	28 (24.5) [14]	31.6 (29.2) [16.2]
Age in males	28.9 (± 11.7) [12.6-70.7]	32.6 (± 12.2) [10.3-66.7]
Age in females	27.5 (± 12.0) [6.2-72.9]	30.6 (± 12.6) [11.8-70.6]
Gender, n (%)
Male	71 (39.6%)	71 (45.8%)
Female	108 (60.3%)	84 (54.2%)
IBD
Disease duration mean, (median), [inter quartile range], yr	10.9 (9.2) [12.8]	8.4 (6.7) [9.9]
Extraintestinal manifestations
Arthralgia	102	79
Uveitis	6	2
Primary sclerosing cholangitis	0	5
Pyoderma gangraenosum	2	3
Erythema nodosum	3	0
Autoimmune hepatitis	0	1
Autoimmune hemolytic anemia	0	1
CD-associated polyneuropathy	1	-
Pulmonary manifestations	1	0
Current medication (% of users)
Prednisolone
Total	37.7	41.3
Systemic	25.7	32.7
Local	13.7	11.3
Local and systemic	1.7	2.7
5-Aminosalicylates
Total	26.3	70.7
Local	1.1	3.3
Immunosuppressants
Total	54.9	30.0
Azathioprine/6-mercaptopurine	46.9	26.4
6-MP	2.9	4.0
Methotrexate	2.3	1.3
Tacrolimus	0.6	4.0
TNF-α-inhibitors	9.1	0.7
Analgesics
Total	29.1	20.7
No information	25.1	32.7
Mean IBD severity, mean, (median), [interquartile range]
CDAI	173 (166) [186]
CAI		5.08 (4.5) [5]
SIBDQ, mean, (median), [interquartile range]	48.3 (49) [21]	46.7 (47) [21]
Males	49.6 (51) [25]	48.9 (48) [22]
Females	47.4 (48) [19]	44.5 (45) [19]
SIBDQ healthy controls	58.5 (59) [10]

CD: Crohn’s disease; UC: Ulcerative colitis; IBD: Inflammatory bowel disease; CDAI: Crohn’s disease activity index; CAI: Colitis activity index; SIBDQ: Short inflammatory bowel disease questionnaire.

Table 2 Multivariate analysis of variables affecting HRQOL

Variable	Mean (95% CI)1	P value
Sex
Female	45.3 (43.0-47.6)	0.607
Male	46.1 (43.4-48.8)
EIM
Yes	48.1 (46.0-47.7)	0.004
No	43.3 (40.2-46.4)
Pain LUQ
Yes	44.6 (41.1-48.2)	0.398
No	46.8 (43.9-50.0)
Pain LLQ
Yes	43.0 (41.0-45.6)	0.001
No	48.3 (45.6-51.1)
Pain RUQ
Yes	46.5 (43.2-49.8)	0.511
No	44.8 (41.6-48.1)
Pain RLQ
Yes	45.5 (43.1-47.8)	0.778
No	45.9 (43.0-48.8)
GI-related surgeries
Yes	46.0 (42.7-49.3)	0.738
No	45.4 (43.1-47.6)
Variable	Regression coefficient estimate2	P value
Age (yr)	0.075	0.244
IBD duration (mo)	0.004	0.635
Pain intensity (0-100 mm)3	-1.734	< 0.0001

Although sex does not affect HRQOL (P = 0.6), EIM (P = 0.0043) and pain in the lower left abdomen (P = 0.0014) do have a significant effect on HRQOL. In addition, pain intensity itself affects HRQOL, whereas sex and disease duration do not influence HRQOL.

¹Adjusted means from analysis of covariance (ANCOVA);

²Change in HRQOL per variable unit increase;

³Visual analog scale (VAS). LUQ: Left upper quadrant; LLQ: Left lower quadrant; RUQ: Right upper quadrant; RLQ: Right lower quadrant.