IBD hurts

Abstract

The importance of quality (QoL) of life, an outcome metric for chronic illnesses, is of increasing importance. In this volume of The Journal, Jacobson et al from British Columbia add to our knowledge of QoL in children with inflammatory bowel disease (IBD). A strength of their approach is that their QoL scores come directly from their patients. They identify that children with well-controlled IBD have mean QoL scores similar to their healthy peers. This is unlike the QoL scores for some other chronic illnesses in good control, such as type 1 diabetes and asthma. However, those with moderately to severely active IBD have some of the lowest QoL scores yet published. Significant clinical factors that impact QoL, independent of disease activity, include school non-attendance and the presence of abdominal pain. Holistic approaches to care, including ensuring and enabling school attendance may be a way to improve QoL in children with IBD. Additionally, they found that patients on methotrexate have a significantly lower QoL score than those receiving azathioprine, whereas they did not find a difference in those patients on or off biologic therapy. Efficacy, cost, and physical or laboratory test side effects are often considered in the choice of a therapeutic agent. Understanding the impact on QoL is another more subjective variable to consider in selecting from a menu of therapeutic options. Awareness of these issues, especially in the setting of a multidisciplinary IBD clinic, allows for exploration of mitigation strategies. Improving pain is paramount. However, offering coping mechanisms for persistent pain can be a way to improve QoL on the path to remission. Article page 57 ▸ Cross-Sectional Analysis of Quality of Life in Pediatric Patients with Inflammatory Bowel Disease in British Columbia, CanadaThe Journal of PediatricsVol. 238PreviewTo evaluate quality of life (QoL) in a large cohort of pediatric patients with inflammatory bowel disease (IBD) and to identify the clinical factors that influence QoL. Full-Text PDF