Aim of the study: The aim of this study was to compare quality of life in a group of patients with severe malabsorption, but who managed without HPN (intestinal insufficiency ~ INS), with a group of patients receiving HPN, using the Inflammatory Bowel Disease Questionnaire 1 (IBDQ) and Sickness Impact Profile 2 (SIP). Methods: All patients included in the study had continuity of care in the Intestinal Failure Unit in Copenhagen, July 1997. The IBDQ and SIP was mailed to 45 patients with INS (defined as a fecal energy loss of more than 2.0 MJ/d, measured by bomb caloriemetry during last submission), and to 57 patients receiving HPN due to benign IF. Written reminders were sent to nonresponders after 2 months and the study was closed for inclusion at 3 months. 39 (87%) patients with INS and 49 (86%) patients receiving HPN returned the questionnaires, but 3 INS patients did not fill out the questionnaires. Results: The two groups did not differ significantly regarding female/male ratio (20/16 and 31/18, respectively) and median age (45 vs. 49 years). Patients receiving HPN had lower BMI than patients with INS (20.8 vs. 22.2 kg/m 2, p < 0.05). In HPN patients the remaining small intestine was shorter (140 vs. 200 cm, p < 0.05), the presence of a stoma more predominant (38/49 vs. 17/36, p <0.05), and fecal weight was higher (1.9 vs. 1.2 kg/day, p < 0.05). Mean IBDQ item scores (0-7, 7=best) in patients with intestinal insufficiency (non-HPN) compared with intestinal failure (HPN) patients: Bowel symptoms; 5.6 vs. 5.3 (n.s), Systemic symptoms; 4.9 vs. 4.1, Emotional function; 5.8 vs. 5.3, and Social function; 4.9 vs. 4.2*. MannWhitney Rank Sum Test, *~p < 0.05. Mean SIP dimensions scores (0-100%, 100=best) in patients with intestinal insufficiency (non-HPN) compared with intestinal failure (HPN) patients: Body care and movement; 96 vs. 90, Mobility 94 vs. 83**, Emotional stability; 90 vs. 82*, Social interaction 89 vs. 82**, Communication; 99 vs. 97, Sleep and rest; 88 vs. 79, Home management; 90 vs. 75**, Recreation/pastimes; 85 vs. 68**, Eating; 98 vs. 90***, Work (+/-); 44 vs. 14*. Chi-square, alternative Fisher's exact test, *~p<0.05, **~p<0.01, ***~p < 0.001. Conclusion: Patients receiving home parenteral nutrition in general had lower scores regarding quality of life measured by IBDQ and SIP than non-HPN patients with intestinal insufficiency, although both groups had relatively high scores. HPN and a central line impose restrictions in daily life regarding social and leisure activities and emotional function. Although physical capability is good in HPN-patients their strength and endurance is limited compared to INS patients, which is reflected in the low employment rate and poor house management. HPN patients also experience more pronounced abdominal pain, reduced appetite, increased malabsorption presenting as increased stool volume and poor nutritional status compared to INS patients. These factors add to the restrictions in daily life imposed by HPN and a life with a central line. 1Guyatt G. etal 1989, 2Bergner M. etal. 1981.