title: Improved health-related quality of life after surgical management of severe refractory constipation-dominant irritable bowel syndrome.
abstract: Irritable bowel syndrome (IBS) is the most common of the functional gastrointestinal disorders (FGIDs). Despite its prevalence and health-care costs, there are few effective therapies for patients with severe symptoms. Our objective was to determine whether surgical management would improve health-related quality of life (HRQOL) in severe refractory constipation-dominant FGIDs. From 2003 to 2005, 6 patients underwent total colectomy with end ileostomy or primary anastomosis. They completed Short Form 36 (SF-36) and IBS-36 questionnaires preoperatively and postoperatively. HRQOL was compared with age- and sex-matched Canadian norms using Welch's unpaired t test. Preoperative SF-36 physical and mental health summary scores were significantly lower than Canadian norms (P < 0.0001), while postoperative scores were not significantly different than Canadian norms (P = 0.50 and P = 0.57, respectively). After surgical management, HRQOL in patients with severe constipation-dominant IBS improved from drastically below that of Canadian norms to a comparable level. This finding questions the convention of avoiding operations in IBS patients and demonstrates that surgical management may be suitable for the appropriately screened patient.
authors.affiliation: 1 Department of General Surgery, Western University, London, Ontario, Canada.
authors.forename: Jennifer Y
authors.initials: JY
authors.lastname: Lam
authors.forename: Biniam
authors.initials: B
authors.lastname: Kidane
authors.forename: Farouq
authors.initials: F
authors.lastname: Manji
authors.forename: Brian M
authors.initials: BM
authors.lastname: Taylor
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003082:Colectomy / Q000379:methods; D003248:Constipation / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D007081:Ileostomy; D043183:Irritable Bowel Syndrome / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D016014:Linear Models; D008875:Middle Aged; D011446:Prospective Studies; D011788:Quality of Life; D012720:Severity of Illness Index; D016896:Treatment Outcome; D055815:Young Adult
keywords: Health-related quality of life; Irritable bowel syndrome; Surgery