Lifestyle restrictions are associated with impaired quality of life but not reduction in relapse in ulcerative colitis.

IF 3.4 Q2 GASTROENTEROLOGY & HEPATOLOGY

Intestinal Research Pub Date : 2025-05-14 DOI:10.5217/ir.2024.00199

Hajime Yamazaki, Masakazu Nagahori, Tadakazu Hisamatsu, Taku Kobayashi, Teppei Omori, Jimmy K Limdi, John T McLaughlin, Shu-Chen Wei, Jovelle Fernandez, Shunichi Fukuhara, Katsuyoshi Matsuoka

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引用次数: 0

Abstract

Background/aims: Patients with ulcerative colitis (UC) in remission commonly restrict thir lifestyle to prevent relapse; however, the effectiveness and impact on quality of life (QOL) is unclear. This study investigated whether lifestyle restrictions are associated with relapse reduction and assessed their impact on QOL.

Methods: This multicenter, prospective cohort study was conducted in Japan (2018-2021) via the YOURS registry, enrolling patients with UC in clinical remission. Patients were followed for 2 years. A baseline questionnaire evaluated lifestyle restrictions in diet, work/study/housework, and physical exercise. QOL was assessed by Disease Impact Scale every 3 months during the first year of follow-up. Associations of lifestyle restrictions with relapse and QOL were assessed by Cox regression analysis and linear mixed-effects models, respectively.

Results: Among 911 patients in clinical remission for > 90 days, 63% had adopted dietary avoidance; 47%, work/study/housework avoidance; and 8%, physical exercise avoidance. Overall, 216 patients relapsed. Lifestyle restrictions were not associated with reduced risk of relapse (multivariableadjusted hazard ratios [95% confidence interval]: dietary avoidance, 1.08 [0.81-1.44]; and work/study/housework avoidance, 1.14 [0.87-1.50]); physical exercise avoidance was associated with increased relapse (multivariable-adjusted hazard ratio, 1.58; 95% confidence interval, 1.02-2.44). All lifestyle restrictions were associated with impaired QOL (P <0.01).

Conclusions: Lifestyle restrictions were not associated with relapse reduction in patients with UC; however, they were associated with impaired QOL. Clinicians should engage in evidence-based discussions with patients with UC in remission regarding lifestyle restrictions (UMIN Clinical Trials Registry; UMIN000031995).

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生活方式限制与生活质量受损有关，但与减少溃疡性结肠炎复发无关。

背景/目的：溃疡性结肠炎（UC）缓解期患者通常会限制其生活方式以防止复发；然而，其有效性和对生活质量（QOL）的影响尚不清楚。本研究调查了生活方式限制是否与复发减少有关，并评估了其对生活质量的影响。方法：这项多中心前瞻性队列研究于2018-2021年在日本通过YOURS注册中心进行，纳入临床缓解的UC患者。随访2年。基线问卷评估饮食、工作/学习/家务和体育锻炼方面的生活方式限制。在随访的第一年，每3个月用疾病影响量表评估生活质量。生活方式限制与复发和生活质量的关系分别通过Cox回归分析和线性混合效应模型进行评估。结果：在临床缓解90天的911例患者中，63%的患者采取了饮食避免；47%，逃避工作/学习/家务；8%的人不愿进行体育锻炼。总的来说，216名患者复发。生活方式限制与复发风险降低无关(多变量校正风险比[95%置信区间]：饮食避免，1.08 [0.81-1.44]；工作/学习/家务回避（1.14 [0.87-1.50]）；避免体育锻炼与复发增加相关(多变量校正风险比，1.58；95%置信区间为1.02-2.44)。所有生活方式限制都与生活质量受损相关(P结论：生活方式限制与UC患者复发减少无关；然而，它们与生活质量受损有关。临床医生应与UC缓解期患者就生活方式限制进行循证讨论(UMIN临床试验登记处；UMIN000031995)。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Intestinal Research GASTROENTEROLOGY & HEPATOLOGY-

CiteScore

7.40

自引率

10.20%

发文量

审稿时长

38 weeks

期刊介绍： Intestinal Research (Intest Res) is the joint official publication of the Asian Organization for Crohn''s and Colitis (AOCC), Chinese Society of IBD (CSIBD), Japanese Society for IBD (JSIBD), Korean Association for the Study of Intestinal Diseases (KASID), Taiwan Society of IBD (TSIBD) and Colitis Crohn''s Foundation (India) (CCF, india). The aim of the Journal is to provide broad and in-depth analysis of intestinal diseases, especially inflammatory bowel disease, which shows increasing tendency and significance. As a Journal specialized in clinical and translational research in gastroenterology, it encompasses multiple aspects of diseases originated from the small and large intestines. The Journal also seeks to propagate and exchange useful innovations, both in ideas and in practice, within the research community. As a mode of scholarly communication, it encourages scientific investigation through the rigorous peer-review system and constitutes a qualified and continual platform for sharing studies of researchers and practitioners. Specifically, the Journal presents up-to-date coverage of medical researches on the physiology, epidemiology, pathophysiology, clinical presentations, and therapeutic interventions of the intestinal diseases. General topics of interest include inflammatory bowel disease, colon and small intestine cancer or polyp, endoscopy, irritable bowel syndrome and other motility disorders, infectious enterocolitis, intestinal tuberculosis, and so forth. The Journal publishes diverse types of academic materials such as editorials, clinical and basic reviews, original articles, case reports, letters to the editor, brief communications, perspective, statement or commentary, and images that are useful to clinicians and researchers.