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Impact of autonomic dysfunction on inflammatory bowel disease
Ashwin N Ananthakrishnan1, Mazen Issa, Alexandru Barboi
1Division of Gastroenterology and Hepatology, Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA.
Journal of Clinical Gastroenterology
|September 4, 2009
Summary
Autonomic dysfunction (AD) in inflammatory bowel disease (IBD) patients is linked to poorer quality of life and increased healthcare use. This suggests a subgroup of IBD patients with AD may face worse health outcomes.
Area of Science:
- Gastroenterology
- Neurology
- Internal Medicine
Background:
- Functional symptoms are prevalent in inflammatory bowel disease (IBD).
- The autonomic nervous system's role in IBD pathogenesis is under investigation.
- Autonomic dysfunction (AD) may contribute to IBD-related functional symptoms and systemic issues.
Purpose of the Study:
- To investigate the impact of clinically apparent autonomic dysfunction (AD) on patients diagnosed with IBD.
- To compare health-related quality of life, disease activity, and healthcare utilization between IBD patients with and without AD.
Main Methods:
- A retrospective case-control study was conducted at a single tertiary referral IBD center.
- Cases included 43 IBD patients diagnosed with AD via standardized testing.
- Three disease-matched controls were selected for each case, with multivariate regression used for comparisons.
Main Results:
- IBD patients with AD were more likely to be female and have psychiatric comorbidity.
- Significantly longer small bowel transit times were observed in IBD patients with AD.
- AD correlated with lower quality of life (SIBDQ scores), increased gastroenterology visits, and higher rates of IBD-related hospitalizations.
Conclusions:
- Clinically manifest AD is associated with diminished quality of life and elevated healthcare utilization in IBD patients.
- IBD patients with AD may constitute a population at risk for adverse health outcomes.
- Further research into managing AD in IBD is warranted to improve patient prognosis.
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