title: Body image dissatisfaction in patients with inflammatory bowel disease.
abstract: BACKGROUND
  Despite the fact that the inflammatory bowel diseases (IBD) and their treatments may affect physical appearance, the effect of IBD on body image is poorly understood. The aims of this study were to determine whether body image dissatisfaction (BID) changes over time in patients with IBD and to examine the demographic and disease-related variables associated with decreased body image.
  
  
  METHODS
  Adults aged 18 and above in the Ocean State Crohn's and Colitis Area Registry with at least 2 years of follow-up were eligible for this study. All patients were enrolled within 6 months of IBD diagnosis and followed prospectively. BID was assessed using a modified version of the Adapted Satisfaction With Appearance questionnaire. Total Adapted Satisfaction With Appearance scores and 2 subscores were calculated. To assess for changes over time, general linear models for correlated data were used for continuous outcomes, and generalized estimating equations were used for discrete outcomes.
  
  
  RESULTS
  Two hundred seventy-four patients were studied. BID was found to be stable over time among men and women with IBD despite overall improvements in disease activity. No differences were found in BID according to IBD subtype. Female gender, greater disease activity, higher symptom burden, longer duration of steroid use, dermatologic and musculoskeletal manifestations of IBD, and ileocolonic disease location among patients with Crohn's disease were associated with greater BID. Greater BID was associated with lower health-related quality of life.
  
  
  CONCLUSIONS
  BID remains stable in an incident cohort of IBD despite improved disease activity and is associated with lower health-related quality of life.
authors.affiliation: *Division of Gastroenterology and Hepatology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin; †Department of Biostatics and Medical Informatics, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin; ‡Division of Gastroenterology, Warren Alpert School of Medicine at Brown University, Providence, Rhode Island; §Department of Pediatric Gastroenterology, Rhode Island Hospital, Providence, Rhode Island; ‖Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Atlanta, Georgia; ¶Crohn's & Colitis Foundation of America, New York, New York; and **Dr. Henry D. Janowitz Division of Gastroenterology, Icahn School of Medicine at Mount Sinai, New York, New York.
authors.forename: Sumona
authors.initials: S
authors.lastname: Saha
authors.forename: Ying-Qi
authors.initials: YQ
authors.lastname: Zhao
authors.forename: Samir A
authors.initials: SA
authors.lastname: Shah
authors.forename: Silvia Degli
authors.initials: SD
authors.lastname: Esposti
authors.forename: Sheldon
authors.initials: S
authors.lastname: Lidofsky
authors.forename: Jason
authors.initials: J
authors.lastname: Shapiro
authors.forename: Neal
authors.initials: N
authors.lastname: Leleiko
authors.forename: Renee
authors.initials: R
authors.lastname: Bright
authors.forename: Meaghan
authors.initials: M
authors.lastname: Law
authors.forename: Heather
authors.initials: H
authors.lastname: Moniz
authors.forename: Zahid
authors.initials: Z
authors.lastname: Samad
authors.forename: Marjorie
authors.initials: M
authors.lastname: Merrick
authors.forename: Bruce E
authors.initials: BE
authors.lastname: Sands
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001828:Body Image / Q000523:psychology*; D015331:Cohort Studies; D004644:Emotions; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000503:physiopathology / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D011379:Prognosis; D011788:Quality of Life; D012042:Registries; D011795:Surveys and Questionnaires; D055815:Young Adult