P024. Ulcerative colitis versus Crohn's disease: differences observed in the IMPACT survey
S. Lönnfors1, J.O. Lindsay2, S. Vermeire3, M. Greco1, D. Hommes3, C. Bell1, L. Avedano1, B. Wilson1, 1European Federation of Crohn's and Ulcerative Colitis Associations, Brussels, Belgium, 2Barts Health NHS Trust, The Royal London Hospital, London, United Kingdom, 3European Crohn's and Colitis Organization, Vienna, Austria
Inflammatory Bowel Diseases (IBD) significantly impacts on a patients' quality of life. No studies have compared the experiences of patients with ulcerative colitis (UC) and Crohn's disease (CD) internationally. A European survey was launched to measure the impact of IBD on quality of life which assessed patients with UC and CD separately.
An online questionnaire was developed based on previously published and conducted surveys and divided into six categories of living with IBD. It was made available in ten languages, tested on six volunteers and offered to patients through 25 national IBD associations across Europe in 2010–2011. The data obtained was analyzed separately for UC and CD.
Of the 4670 respondents 63% had CD and 33% UC. The self-reported current disease activity was similar in both groups. More UC patients were diagnosed within 6 months from symptom onset (UC 46%, CD 26%; p < 0.001). More CD than UC patients visited emergency department at least once before diagnosis.
UC patients experienced more bowel urgency and rectal bleeding during their last flare than CD patients. More CD than UC patients reported joint and skin involvement and regular use of painkillers. CD patients were hospitalized more frequently, but UC patients stayed in hospital longer.
Significantly more UC than CD patients were currently taking aminosalicylates (UC 72%, CD 35%) and corticosteroids (UC 25%, CD 18%), whereas more CD patients were treated with immunosuppressives (CD 36%, UC 27%; p < 0.001) and biologics (CD 36%, UC 12%; p < 0.001). More CD patients had had surgery (CD 56%, UC 12%; p < 0.001) and complications of surgery (CD 20%, UC 5%; p < 0.001).
CD patients reported more sick days in the past year, discrimination at work and negative impact of IBD on career path. More CD than UC patients had lost a job due to IBD. CD patients were more often absent due to hospital or emergency department visits and abdominal pain, whereas more UC patients were absent due to incontinence or fear of it, fear of toilet frequency interrupting work, worry about gas, discomfort or volume of bleeding.
IBD significantly impacts the patients' quality of life. The symptoms, current therapies, and personal experiences of UC and CD patients, however, are different. The differences should be looked into more deeply to be able to offer more individually targeted therapies to UC and CD patients.