Improved health-related quality of life after surgical management of severe refractory constipation-dominant irritable bowel syndrome

• Published in: International surgery Vol. 100; no. 1; pp. 63 - 69
• Main Authors: Lam, Jennifer Y, Kidane, Biniam, Manji, Farouq, Taylor, Brian M
• Format: Journal Article
• Language: English
• Published: Italy The International College of Surgeons, World Federation of General Surgeons and Surgical Specialists, Inc 01-01-2015
• Subjects: Adolescent; Adult; Aged; Colectomy - methods; Colorectal Surgery; Constipation - diagnosis; Constipation - etiology; Constipation - surgery; Female; Health Status Indicators; Humans; Ileostomy; Irritable Bowel Syndrome - complications; Irritable Bowel Syndrome - diagnosis; Irritable Bowel Syndrome - surgery; Linear Models; Middle Aged; Prospective Studies; Quality of Life; Severity of Illness Index; Treatment Outcome; Young Adult; Health-related quality of life; Surgery; Irritable bowel syndrome
• ISSN: 0020-8868; 2520-2456
• DOI: 10.9738/INTSURG-D-13-00212.1

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.