Evaluating Quality of Life in Surgically Treated IBD Patients: A Systematic Review of Physical, Emotional and Social Impacts.

Background and

Objectives

Inflammatory Bowel Disease, including Crohn's Disease and Ulcerative Colitis, affects patients' Quality of Life through various and complex chronic gastrointestinal symptoms. When medical treatment protocols are ineffective, surgical options like a colectomy, ileostomy, or Ileal Pouch Anal Anastomosis may be necessary, offering symptom relief but presenting new psychological, emotional, and social issues.

Objectives

This systematic review evaluates the impact of surgery on quality of life in Inflammatory Bowel Disease patients from 2018 to 2023, focusing on physical, emotional and social outcomes as well as long-term quality of life predictors. Materials and

Methods

We searched PubMed, Scopus, and Cochrane Library for studies assessing Quality of Life in surgically treated Inflammatory Bowel Disease patients, including physical and psychological outcomes. Non-English studies were excluded. Risk of bias was evaluated using Cochrane and Newcastle-Ottawa tools, with data synthesized narratively and via random-effects meta-analysis.

Results

Of 2450 records screened, 58 studies (45 in meta-analysis) were included, covering colectomy, ileostomy and Ileal Pouch Anal Anastomosis. Surgery significantly improved physical quality of life in 90% of patients, but psychological and social challenges persisted, with 38% reporting body image issues and 34% experiencing social isolation. Psychological support improved emotional quality of life by 20-30%. Long-term quality of life varied, with IPAA patients showing higher satisfaction (70% at 5 years) than Crohn's Disease patients with resections.

Conclusions

Surgery enhances physical quality of life in Inflammatory Bowel Disease patients, but requires multidisciplinary care to address persistent psychological and social challenges, ensuring optimal long-term outcomes.