Quality of life in inflammatory bowel disease: a systematic review and meta-analyses—part II
Open accessAbstract
Background: There has been burgeoning interest in quality of life (QoL) in inflammatory bowel disease (IBD) in recent decades, with hundreds of studies each year now assessing this outcome. This paper is part 2 of a systematic review evaluating 5 key QoL comparisons within IBD states and relative to others without IBD. Part 1 examined QoL comparing IBD and a healthy/general population and other medically ill groups. Part 2, presented here, examines within-disease comparisons of active/inactive disease, Ulcerative colitis (UC) / Crohn's disease (CD), and change in QoL over time. Outcomes using generic versus IBD-specific QoL measures were also examined. Methods: Adult and pediatric studies were identified through systematic searches of 7 databases from the 1940s (where available) to October 2015. Results: Of 6173 abstracts identified, 466 were selected for final review based on controlled design and validated measurement, of which 83 unique studies (75 adult, 8 pediatric) addressed the within-disease comparisons. The pooled mean QoL scores were significantly lower in active versus inactive IBD (n = 26) and for those with CD versus UC (n = 37), consistent across IBD-specific and generic QoL measures, for almost all comparisons. There was significant improvement in QoL over time (n = 37). Study quality was generally low to moderate. The most common measures of QoL were the disease-specific Inflammatory Bowel Disease Questionnaire and generic 36-Item Short Form Survey (SF-36) (adults) and the IBD-specific IMPACT (children). Conclusions: For adults in particular, there was strong confirmation that QoL is poorer during active disease and may be poorer for those with CD. The finding that QoL can improve over time may be encouraging for individuals with this chronic disease.
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IBD considerably impacts quality of life and raises the risk of developing mental health problems.
“Inflammatory bowel disease (IBD) considerably impacts the quality of life and raises the risk of developing mental health problems (Knowles et al., 2018).”
From Randomized controlled trial of an Acceptance and Commitment Therapy and compassion-based group intervention for persons with inflammatory bowel disease: the LIFEwithIBD intervention (2024) · cites this paper as Knowles et al., 2018
The Introduction (p. 1) says patients with IBD often report impaired quality of life and have higher rates of comorbid anxiety and depression than healthy controls. The Results and Conclusions (p. 1) also report poorer quality of life during active disease. Higher rates of comorbid conditions do not establish that IBD raises the risk of subsequently developing mental health problems. (LLM, conf=0.88)
Experimental — accuracy not yet measuredPeople with IBD experience a consistently poor quality of life both during disease flare-ups and remission.
“Our meta-analyses found that people with IBD experience a consistently poor quality of life (QoL) both during disease flare-ups and remission.6 7”
From Acceptance commitment therapy (ACT) for psychological distress associated with inflammatory bowel disease (IBD): protocol for a feasibility trial of the ACTforIBD programme (2022) · cites this paper as [6]
The Results (p. 3) and Discussion (p. 8) find that quality of life is poorer during active IBD than during inactive disease. This supports the flare-up portion, but this paper’s within-disease comparisons do not establish that quality of life is consistently poor during remission; the Discussion also reports improvement over time. (LLM, conf=0.86)
Experimental — accuracy not yet measured
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- Authors
- Knowles, S. R., Keefer, L., Wilding, H., Hewitt, C., Graff, L. A., & Mikocka-Walus, A.
- Affiliations
- The Royal Melbourne Hospital (AU)
- Icahn School of Medicine at Mount Sinai (US)
- St Vincent's Hospital Melbourne (AU)
- University of York (GB)
- University of Manitoba (CA)
- Department of Health Sciences, University of York, York, United Kingdom
- Corresponding author
- Knowles, Simon R
- Venue
- Inflammatory Bowel Diseases
- Publisher
- Oxford University Press (OUP)
- Published
- 2018-04-23
- Volume
- 24
- Issue
- 5
- Pages
- 966-976
- ISSN
- 1078-0998 (ISSN-L)
- 1536-4844
- OpenAlex
- W2801602793
- Cited by
- 416
- References
- 146
- Citations by year
- 2026: 26 · 2025: 53 · 2024: 73 · 2023: 83 · 2022: 55 · 2021: 61 · 2020: 35 · 2019: 24 · 2018: 6
- FWCI
- 4.57
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Inflammatory Bowel Diseases (publishedVersion)
- PubMed (publishedVersion)
- Own your potential (DEAKIN) (submittedVersion)
- Figshare (submittedVersion, cc-by)
- Swinburne figshare (Swinburne University of Technology) (submittedVersion)
- Topics
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Inflammatory Bowel Disease
- Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Health Systems, Economic Evaluations, Quality of Life
- Health Sciences › Medicine › Ophthalmology › Ocular Diseases and Behçet’s Syndrome
- Keywords
- quality of life, inflammatory bowel disease
- MeSH terms
- Adult, Child, Colitis, Ulcerative, Crohn Disease, Humans, Quality of Life, Surveys and Questionnaires
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