Health-related quality of life in inflammatory bowel disease

Inflammatory bowel disease (IBD) is characterised by a chronic, but frequently remitting, clinical course involving significant morbidity. As medical and surgical advances have occurred, focus has shifted from merely reducing mortality to efforts on decreasing morbidity and improving health status. With this paradigm shift has come the need for qualitative and quantitative assessment of outcomes important to the individual patient. Existing disease activity measures fall short in this area. Health-related quality of life encompasses the areas of physical function, somatic sensation, psychological state and social interactions that are affected by one's health status. Instruments have recently been developed for both generic and disease-specific health states, such as IBD. These psychometric measures have proven to be useful tools for patient assessment. Both medical and surgical trials have incorporated these measures as salient outcomes. An additional outcome that has come under closer scrutiny is the cost of medical interventions. The literature on the cost of IBD is sparse but is likely to increase logarithmically in the future. Quality of life and cost issues are becoming central to the study of not just IBD but all of medicine.