Evaluation of nutritional status and quality of life before and after IPAA surgery of patients with severe ulcerative colitis

Abstract

Objective To evaluate the effects of restorative proctocolectomy with ileal pouch-anal anastomosis (IPAA) on nutritional status and quality of life of patients with severe ulcerative colitis (UC) . Methods A total of 64 UC patients′ nutritional status and quality of life, who met the inclusion criteria and underwent IPAA surgery, were assessed by multiple nutritional evaluation indexes and the Chinese version of the inflammatory bowel disease quality of life questionnaire (IBDQ) before IPAA, three months after IPAA and three months after ileostomy closure respectively. The effects of IPAA surgery on nutritional status and quality of life were analyzed, and the data of quality of life were compared with reference values from 64 healthy people. Results Before IPAA, the prevalence of subnormal levels of body mass index (BMI) , hemoglobin (Hb) , serum concentrations of albumin (ALB) , prealbumin (PA) and transferrin (TFN) were 40.63%, 78.13%, 59.38%, 73.44%, 58.30% lower than the normal reference. Three months after IPAA, the prevalence of subnormal levels of BMI, Hb, ALB, PA and TFN were 35.94%, 4.69%, 3.13%, 34.38%, 0. Three months after ileostomy closure, the prevalence of subnormal levels of BMI, Hb, ALB, PA and TFN were 20.31%, 7.81%, 0, 6.25%, 0. The overall IBDQ before IPAA were 44.54 and 76.53 for 3 months after IPAA that all were lower than those of the healthy people with statistical significances (t=41.19, 9.26; P 0.05) . The overall quality of life and four domains scores were similar to the healthy population three months after ileostomy closure with no statistical significance (P>0.05) . Conclusions The nutritional status and quality of life of UC patients before IPAA were poor. IPAA surgery can significantly improve the nutritional status and quality of life of UC patients. Key words: Ulcerative colitis; Quality of life; Nutritional status; Surgical treatment