IBD-Disk: A simple tool for correlating disability with mucosal healing and endoscopic activity in inflammatory bowel disease

Aims The IBD-Disk is a validated 10-question, self-administered visual questionnaire used to assess the inflammatory bowel disease (IBD) related disability. It has been shown that IBD-Disk aligns effectively with the clinical activity reported by either the patient or the practitioner. Nevertheless, only a limited number of studies have investigated its associations with more objective activity scores, such as endoscopic findings.

Methods We conducted a monocentric, cross-sectional study from April to September 2023. All Crohn’s Disease (CD) and ulcerative colitis (UC) patients who underwent a colonoscopy during follow-up or hospitalization were invited to complete the IBD-Disk questionnaire. Endoscopic activity in CD was evaluated via the “Simple Endoscopic Score for Crohn’s Disease” (SES-CD), and in UC via the “Ulcerative Colitis Endoscopic Index of Severity” (UCEIS). A moderate-to-severe disability was defined by an overall IBD-Disk score≥40.

Results We included 61 patients, 47.5% were male and 60.7% had CD. The mean age was 37.8±11.7 years. The mean overall IBD score was 42.2±22.5. “Education and work”, “Energy” and “Emotions” scored the highest among all subscores (5.6±3.2, 5.5±3.0, 5.5±2.9 respectively). Mucosal healing was observed in CD and UC at rates of 21.6% and 16.7%, respectively. A mild activity was noted in 29.7% and 29.1% of cases of CD and UC respectively. Moderate endoscopic activity was noted in 15 patients with CD and 7 patients with UC. Severe activity was observed in 3 and 6 patients with CD and UC, respectively. A significant difference was observed between the overall means of IBD-Disk in patients with mucosal healing compared to those with endoscopic activity (16.7±13.5 vs 48.5±19.8, p<0.001). Furthermore, IBD-Disk was strongly correlated with the endoscopic activity levels of UCEIS and SES-CD (r=0.687 and 0.534 respectively, p<0.001). “Abdominal pain” showed the highest correlation with UCEIS and SES-CD (r=0.678 and r=0.561 respectively, p<0.001). However, “Joint pain” showed the weakest correlation with UCEIS (r=0.332, p<0.001) and “Emotions” with SES-CD (r=0.205, p<0.001). A moderate-to-severe disability was observed in 52.5% of our population (48.6% for CD and 58.3% for UC). Furthermore, Our study demonstrated that the endoscopic activity of IBD was significantly associated with moderate to severe disability (p=0.001), independent of the underlying disease type (SES-CD: p=0.042 and UCEIS: p=0.020).

Conclusions Our study revealed that moderate-to-severe disability according to the IBD-Disk is significantly associated with endoscopic activity in IBD. Additionally, we demonstrated a strong correlation between the overall IBD-Disk score and the severity of the observed endoscopic lesions. This emphasizes the need to achieve mucosal healing in order to reduce the IBD-related disability.

 

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Conflicts of interest

Authors do not have any conflict of interest to disclose.

Publikationsverlauf

Artikel online veröffentlicht:
15. April 2024