Mucosal healing and quality of life in therapeutic goals of ulcerative colitis: occurrence and related factors of functional bowel disorder-like symptoms

Lihui Lin; Tianqi Wang; Yaming Lu; Peng Chen; Yingfan Zhang; Xiaoman Zu; Baili Chen; Ren Mao; Rui Feng; Yi Cui; Shenghong Zhang; Yao He

doi:10.1177/17562848221092597

Mucosal healing and quality of life in therapeutic goals of ulcerative colitis: occurrence and related factors of functional bowel disorder-like symptoms

Therap Adv Gastroenterol. 2022 Apr 29:15:17562848221092597. doi: 10.1177/17562848221092597. eCollection 2022.

Authors

Lihui Lin¹, Tianqi Wang², Yaming Lu¹, Peng Chen¹, Yingfan Zhang¹, Xiaoman Zu¹, Baili Chen¹, Ren Mao¹, Rui Feng¹, Yi Cui¹, Shenghong Zhang³, Yao He³

Affiliations

¹ Division of Gastroenterology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, P.R. China.
² Division of Science and Technology, Beijing Normal University-Hong Kong Baptist University United International College, Zhuhai, P.R. China.
³ Division of Gastroenterology, The First Affiliated Hospital, Sun Yat-sen University, 58 Zhongshan Road 2, Guangzhou 510080, P.R. China.

Abstract

Background: Mucosal healing (MH) is considered the preferred therapeutic target for ulcerative colitis (UC). Impaired quality of life (QoL), irritable bowel syndrome (IBS)-like symptoms, and functional bowel symptoms have been reported in several inactive patients with UC. This study aims to assess the occurrence of functional bowel disorders (FBD)-like symptoms and QoL in UC patients with MH, and to explore the factors related to FBD-like symptoms.

Methods: UC patients with MH (Mayo endoscopic score, MES = 0 or 1) were required to complete the Rome IV diagnostic questionnaire, the 32-item version of Inflammatory Bowel Disease Questionnaire (IBDQ-32), the 36-item short form healthy survey questionnaire (SF-36), and the Hospital Anxiety and Depression Scale (HADS). UC patients who did not achieve MH (MES > 1) completed the IBDQ-32, the SF-36, and the HADS. Community-dwelling healthy controls (HCs) completed the SF-36 and the HADS.

Results: Among the 119 UC patients with MH recruited, 45.4% reported functional bowel symptoms; functional constipation-like symptom (13.4%) was the most prevalent, followed by IBS-like symptom (10.9%), and functional diarrhea-like symptom (10.0%). The IBDQ-32 and SF-36 scores were significantly lower in MH patients with FBD-like symptoms than in those without FBD-like symptoms. Disease duration [odds ratio (OR): 1.022; p < 0.001], body mass index (BMI; OR: 0.726; p < 0.001) were independent predictors of FBD-like symptoms in UC patients with MH. Combining these two factors could attain area under the curve [0.786; 95% confidence interval (CI): 0.701-0.856, p < 0.001] to predict FBD-like symptoms in MH patients.

Conclusion: A number of UC patients with MH had accompanying FBD-like symptoms and significantly impaired QoL. Disease duration, BMI could predict the occurrence of FBD-like symptoms.

Keywords: Rome IV criteria; functional bowel disorder-like symptoms; mucosal healing; quality of life; ulcerative colitis.