IBD Surgery Improves Patient-Reported Pain - EMJ

Inflammatory Bowel Disease Surgery Improves Patient-Reported Pain

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PATIENTS who underwent surgery for inflammatory bowel disease (IBD) reported better physical health 1 month after surgery, according to findings presented at the Crohn’s & Colitis Congress, Las Vegas, Nevada, USA.

Stefan Holubar, Cleveland Clinic, Ohio, USA, and team, analysed data from the first 103 patients enrolled in the Crohn’s & Colitis Foundation’s IBD Plexus, a prospective longitudinal multicentre surgical cohort (median age: 43 years; 49% female; 64% Crohn’s disease, 35% ulcerative colitis; 1% unspecified IBD). The analysis included responses from patients on the PROMIS General Health measures; the PROMIS Pain, Fatigue, and Sleep scales; and the Crohn’s & Ulcerative Colitis Questionnaire.

Patients reported one average point lower on a 1–6 pain scale (3 to 2; P=0.04) in postoperative surveys, compared to pre-operative surveys conducted 2 weeks before surgery. The proportion of patients reporting ‘good to excellent’ physical health also increased from 59% to 77.8% (P=0.03) after surgery, and 83% reported ‘good to excellent’ overall health 30 days after surgery, compared with 67% 2 weeks before surgery (P=0.04).

However, patient-reported social and emotional outcomes rated as ‘good to excellent’ were similar before and after surgery for quality of life (74% and 83%; P=0.27), mental health (74% and 70%; P=0.68), social satisfaction (65% and 69%; P=0.70), and the ability to perform socially (61% and 65%; P=0.65). The difference between those reporting emotional problems ‘sometimes to always’ in the past 7 days before surgery (70%) and after surgery (54%) was also non-significant (P=0.07). Similarly, the difference in patients who reported feeling upset ‘most to all of the time’ before (19%) and after (10%) surgery was not significant (P=0.15).

As noted by Holubar, patients are still recovering 30 days after surgery, and longer follow-up periods may reveal further improvements in physical and emotional health. “Targeted psychosocial interventions and support at home early in the acute postoperative period may improve the quality of recovery after surgery for IBD patients,” he concluded.

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