Abstract
BackgroundInflammatory bowel disease (IBD) is a debilitating chronic disease characterised by inflammation and ulceration of the gastrointestinal tract. It is associated with a range of debilitating symptoms and reduced quality of life. People living with IBD may also be at risk of body image dissatisfaction (BID). BID is a distorted and negative view of the physical self, which in turn can adversely affect mental health and quality of life. To date, there have been no systematic reviews of the evidence on BID in IBD patients. Therefore, the aim of this systematic review is to clarify the evidence base on BID in *IBD patients including (i) the tools used to measure BID, (ii) the prevalence and severity of BID, (iii) the risk factors associated with BID and (iv) the relationship between BID and quality of life.MethodsBibliographic databases (EMBASE, MEDLINE, PsycINFO, Cochrane CENTRAL) will be searched using a sensitive search strategy aiming to identify any quantitative study reporting on body image in the context of IBD. This will be supplemented by searches of ongoing trials registers and checking of reference lists. Studies will be assessed for eligibility using predetermined selection criteria for each question. Data will be extracted using a predefined data extraction form, and risk of bias (quality) of included studies will be assessed based on checklists appropriate to the study designs identified. Key methodological steps will be undertaken in duplicate to minimise bias and error. Synthesis will be undertaken separately for the different systematic review sub-questions. Given the anticipated heterogeneity of evidence on each question, it is likely that synthesis will be mostly narrative.DiscussionTo the best of our knowledge, this will be the first systematic review to collate the existing evidence on BID in IBD patients. Understanding the impact of BID, its relationship with quality of life, and which patients may be at greater risk, may ultimately lead to the development of interventions to prevent or treat BID and to better patient care. Any gaps in the identified evidence will help to inform the research agenda in this area.Systematic review registrationPROSPERO: (CRD42018060999).
Highlights
Inflammatory bowel disease (IBD) is a debilitating chronic disease characterised by inflammation and ulceration of the gastrointestinal tract
IBD consists of two main forms: Crohn’s disease and ulcerative colitis [1]
As body image has been highlighted as an issue in other conditions such as cancer and in transplant patients [31], it is possible it may impact on IBD patients too
Summary
This systematic review protocol has been prepared according to the Preferred Reporting Items of Systematic Reviews and Meta-Analysis Protocols (PRISMA-P) [34] statement and is registered on PROSPERO (CRD42018060999). Include: studies that report prevalence/frequency and severity of BID (including mean/median body image scores) in IBD patients. Include: studies where data is reported on associations between any factor in inflammatory bowel disease patients and BID. Include: studies that have looked at the association between results from body image tools and quality of life tools in patients with a diagnosis of inflammatory bowel disease. Other study designs may report relevant data; for example, relevant cross-sectional data may be presented in the context of a randomised controlled trial In this case, the quality items for cross-sectional studies will still be relevant. Relevant outcome metrics that would be considered for pooling are BID prevalence proportions or mean body image scores, odds ratios/risk ratios or correlation coefficients relating to the association between different factors. If meta-analysis is not feasible, it may still be possible to present findings in forest plots (without pooling) for illustrative purposes
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