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The Impact of Ostomy on Quality of Life and Functional Status of Crohn's Disease Patients

Abdalla, Maisa I. MD, MPH; Sandler, Robert S. MD, MPH; Kappelman, Michael D. MD, MPH; Martin, Christopher F. MSPH; Chen, Wenli MA, MS; Anton, Kristen MS; Long, Millie D. MD, MPH

doi: 10.1097/MIB.0000000000000930
Original Clinical Articles

Background: The potential need for an ostomy is a main concern for patients with inflammatory bowel disease. We performed this study to evaluate the impact of a long-term ostomy (≥6 mo duration) on the functional status and specific patient-reported outcomes in a population of patients with Crohn's disease (CD).

Methods: We performed a cross-sectional analysis within the Crohn's and Colitis Foundation of America Partners cohort. Bivariate analyses and logistic regression models were used to investigate associations between ostomy and various demographic, disease factors, and patient-reported outcomes for health-related quality of life.

Results: A total of 402 CD patients with ostomy for a minimum duration of 6 months were compared with 4331 CD patients with no ostomy. Patients with ostomy were more likely to be in clinical remission compared with those without ostomy, 48.5% versus 31.3%, respectively. Having an ostomy did not impact the overall health-related quality of life and was not associated with anxiety, depression, sleep disturbances, or reduced sexual interest and satisfaction. However, the presence of ostomy was associated with reduced social role satisfaction in both patients with controlled and active disease. Additionally, in the subset of patients who did not achieve clinical remission, those with ostomy experienced greater pain interference (odds ratio, 1.63; 95% confidence interval, 1.12–2.35) and fatigue (odds ratio, 1.66; 95% confidence interval, 1.15–2.39).

Conclusions: Ostomy is well tolerated in CD patients, particularly when clinical remission is achieved.

Article first published online 21 September 2016.

*Department of Medicine, Division of Gastroenterology and Hepatology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; and

Department of Pediatrics, Division of Pediatric Gastroenterology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.

Address correspondence to: Maisa I. Abdalla, MD, MPH, Department of Medicine, Division of Gastroenterology and Hepatology, University of North Carolina at Chapel Hill, Campus Box #7080, 130 Mason Farm Road, Bioinformatics Building, Chapel Hill, NC 27599-7080 (e-mail: misaabdalla@gmail.com).

Supported by the Crohn's and Colitis Foundation of America, Patient Centered Outcomes Research Institute, and the National Institutes of Health (Grants numbers: NIH P30 DK34987 and NIH 1K08DK088957–01).

Presented as an abstract at Digestive Disease Week, San Diego, CA, May 23, 2016.

M. D. Long has consulted for Abbvie, Salix, Pfizer and Theravance pharmaceuticals. M. D. Kappelman has consulted for Abbvie, Janssen, Celgene, and GlaxoSmithKline and has received support from Abbvie, Janssen, and GlaxoSmithKline. The remaining authors have no conflict of interest to disclose.

Received July 30, 2016

Accepted August 07, 2016

© Crohn's & Colitis Foundation of America, Inc.
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