Evaluation of quality of life with IBD-disk score in patients with inflammatory bowel disease

Introduction: Inflammatory bowel diseases (IBD) are chronic inflammatory diseases characterized by idiopathic, exacerbation and recovery periods, which is thought to occur with the effect of environmental and immunological factors in individuals with genetic predisposition. Ulcerative colitis (UC) and Crohn's disease (CD) are two common forms of inflammatory bowel diseases, and approximately 5- 15% of IBD are clinically and pathologically indistinguishable IBD Unclassifed cases. In Europe, the incidence for CD varies between 0.7-9.8 per 100,000 people and the incidence for UC varies between 1.5-20.3 per 100,000 people. Patient- reported outcomes (PRO) are important in the management of the patient's treatment, as both UC and CD cause disability, which can lead to deterioration in physical, psychological, familial and social life and reduce the quality of life of patients. A self-administered visual tool, the IBD-Disc (Inflammatory Bowel Disease) questionnaire, was developed to measure disability in patients with IBD. In our study, we aimed to evaluate the correlation between IBD-Disc scores before and after treatment and endoscopic and pathological scores before and after treatment in UC and CD groups, and to evaluate quality of life with IBD-Disc score in IBDs. Material and Method: Patients aged between 18-80 years, followed up with the diagnosis of IBD or newly diagnosed, who applied to our clinic consecutively between July 2021 and July 2022 were included in the study. The clinical and demographic characteristics of the patients who signed the informed consent form were recorded. Laboratory tests, endoscopic and pathological findings were recorded before treatment change was made in the case of activation in those under follow-up and before treatment initiation in newly diagnosed patients. A baseline IBD-Disc questionnaire was administered to the patients before treatment initiation or treatment change. Then, survey questions were asked in the same way in the first week, first month and third month of the treatment. Clinical activity scores and laboratory measurements were repeated at the same frequency as the questionnaire questions. Endoscopic and pathological evaluations of the patients were performed at the 3rd month after the start or change of treatment. The obtained questionnaire v results were compared with each other and with the clinical, endoscopic and histopathological changes of the disease. Results: The groups are homogeneous in terms of age and gender. In the UC group, 3rd month hemoglobin values were found to be significantly higher than the basal hemoglobin values. Nancy Histological Index (NHI) score and Mayo Endoscopic Score (MES) measured at baseline in the UC group were significantly higher than the score measured at 3 months. In the CD group, 3rd month hemoglobin values were found to be significantly higher than basal hemoglobin values and 3rd month leukocytes and International Normalized Ratio (INR) values were found to be significantly lower than basal leukocyte values. The Simple Endoscopic Score for Crohn's Disease (SES-CD) score measured at baseline in the CD group was found to be significantly higher than the SES-CD score measured at 3 months. A positive significant correlation was found between the changes in NHI between 0 and 3 months and the changes in UC-MES scores between 0 and 3 months in the UC group. A positive significant correlation was found between the changes in NHI between 0 and 3 months and the changes in SES-CD scores between 0 and 3 months in the CD group. Conclusion: It was determined that the baseline IBD-Disc general and all sub- scores were significantly higher after the treatment in the UC and CD groups compared to the 3rd month measurements. A significant correlation was found between endoscopic findings and pathological scores in the UC and CD groups, but no significant positive correlation was found between IBD-Disc scores and endoscopic and pathological scores. We hope that our study will shed light on future studies on this subject. Keywords: Ulcerative colitis, Crohn's disease, IBD-Disc, Nancy histological index