Skip to main content
Log in

Impact of Inflammatory Bowel Disease on Disability

  • Inflammatory Bowel Disease (S Hanauer, Section Editor)
  • Published:
Current Gastroenterology Reports Aims and scope Submit manuscript

Abstract

Inflammatory bowel disease can impact individuals at a young age, thus compromising their work productivity. Besides the inability to engage in gainful work, the concept of disability also relates to the patients’ diminished ability to undertake household and social activities. A literature search was performed of recent literature, and all articles containing information about the impact of inflammatory bowel disease on disability or any work-related outcomes were included. Recent studies suggest that 9 to 19 % of inflammatory bowel disease patients suffer from short-term absences from work and 19 to 22 % are on long-term disability. Crohn’s disease patients reported being more affected by their disease than ulcerative colitis patients. A comparison of results from different studies is difficult due to the lack of consensus on how to define and measure disability. Additional research is needed to better quantify disability in inflammatory bowel disease patients.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1

Similar content being viewed by others

References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. WHO. World Report on Disability: World Health Organization, 2011. http://www.who.int/disabilities/world_report/2011/en/. This first report on disability suggests that more than a billion people in the world today experience disability. The report summarizes the evidence on how to overcome barriers to health care, rehabilitation, education, employment, and support services and provides a concrete set of recommended actions for policy-makers, service providers, and professionals.

  2. Israeli E, Graff LA, Clara I, et al. Low prevalence of disability among patients with inflammatory bowel diseases a decade after diagnosis. Clin Gastroenterol Hepatol. 2014;12:1330–7. This study aimed to examine disability a decade after diagnosis in a population-based cohort of 244 IBD patients in Manitoba, Canada, and found that mean levels of disability were significantly higher among patients with CD than those with UC.

    Article  PubMed  Google Scholar 

  3. WHO. International Classification of Functioning, Disability and Health (ICF). Geneva: World Health Organization, 2001. http://www.who.int/classifications/icf/icf_more/en/.

  4. Ustun TB, Chatterji S, Kostanjsek N, et al. Developing the World Health Organization disability assessment schedule 2.0. Bull World Health Organ. 2010;88:815–23.

    Article  PubMed  PubMed Central  Google Scholar 

  5. Bernstein CN, Blanchard JF, Rawsthorne P, et al. Epidemiology of Crohn’s disease and ulcerative colitis in a central Canadian province: a population-based study. Am J Epidemiol. 1999;149:916–24.

    Article  PubMed  CAS  Google Scholar 

  6. Busch K, Da Silva S, Holton M, et al. Sick leave and disability pension in inflammatory bowel disease: a systematic review. J Crohn’s Colitis. 2014. doi:10.1016/j.crohns.2014.06.006. This study aimed to systematically review evidence on work-related outcomes in IBD patients and to evaluate whether medical or surgical interventions have a positive impact on patients’ work ability. While biologic agents showed positive effect on work absenteeism and presenteeism in randomized clinical trials, the impact of surgical interventions needs further evaluation.

    Google Scholar 

  7. Cohen RD, Yu AP, Wu EQ, et al. Systematic review: the costs of ulcerative colitis in Western countries. Aliment Pharmacol Ther. 2010;31:693–707.

    Article  PubMed  CAS  Google Scholar 

  8. Peyrin-Biroulet L, Cieza A, Sandborn WJ, et al. Development of the first disability index for inflammatory bowel disease based on the international classification of functioning, disability and health. Gut. 2012;61:241–7.

    Article  PubMed  PubMed Central  Google Scholar 

  9. Liberati A, Altman DG, Tetzlaff J, et al. The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. Ann Intern Med. 2009;151:W65–94.

    Article  PubMed  Google Scholar 

  10. Nurmi E, Haapamaki J, Paavilainen E, et al. The burden of inflammatory bowel disease on health care utilization and quality of life. Scand J Gastroenterol. 2013;48:51–7.

    Article  PubMed  Google Scholar 

  11. Neovius M, Arkema EV, Blomqvist P, et al. Patients with ulcerative colitis miss more days of work than the general population, even following colectomy. Gastroenterology. 2013;144:536–43. This study aimed to estimate the burden of sick leave and disability pension in a population-based cohort of patients with UC and the effects of colectomy. Overall, patients with UC miss more work days than matched controls from the general population in Sweden.

    Article  PubMed  Google Scholar 

  12. Reilly MC, Gerlier L, Brabant Y, et al. Validity, reliability, and responsiveness of the work productivity and activity impairment questionnaire in Crohn’s disease. Clin Ther. 2008;30:393–404.

    Article  PubMed  Google Scholar 

  13. Vergara M, Montserrat A, Casellas F, et al. Development and validation of the Crohn’s disease perceived work disability questionnaire. Inflamm Bowel Dis. 2011;17:2350–7.

    Article  PubMed  Google Scholar 

  14. Hoivik ML, Bernklev T, Solberg IC, et al. Patients with Crohn’s disease experience reduced general health and vitality in the chronic stage: ten-year results from the IBSEN study. J Crohn’s Colitis. 2012;6:441–53.

    Article  Google Scholar 

  15. Hoivik ML, Moum B, Solberg IC, et al. Work disability in inflammatory bowel disease patients 10 years after disease onset: results from the IBSEN Study. Gut. 2013;62:368–75. This study aimed to compare the work disability rate in IBD patients 10 years after disease onset, with the work disability rate in the background population. Ten years after disease onset IBD patients had an increased relative risks for disability pension as compared with the background population.

    Article  PubMed  Google Scholar 

  16. Siebert U, Wurm J, Gothe RM, et al. Predictors of temporary and permanent work disability in patients with inflammatory bowel disease: results of the swiss inflammatory bowel disease cohort study. Inflamm Bowel Dis. 2013;19:847–55.

    Article  PubMed  Google Scholar 

  17. Viazis NMG, Karmiris K, Polymeros D, Kouklakis G, Maris T, Karagiannis J, et al. Inflammatory bowel disease: Greek patients’ perspective on quality of life, information on the disease, work productivity and family support. Ann Gastroenterol. 2013;26:52–8.

    PubMed  PubMed Central  Google Scholar 

  18. Mundt JC, Marks IM, Shear MK, et al. The Work and Social Adjustment Scale: a simple measure of impairment in functioning. Br J Psychiatry. 2002;180:461–4.

    Article  PubMed  Google Scholar 

  19. Allen PB, Kamm MA, Peyrin-Biroulet L, et al. Development and validation of a patient-reported disability measurement tool for patients with inflammatory bowel disease. Aliment Pharmacol Ther. 2013;37:438–44.

    Article  PubMed  CAS  Google Scholar 

  20. Peyrin-Biroulet L, Cieza A, Sandborn WJ, et al. Disability in inflammatory bowel diseases: developing ICF Core Sets for patients with inflammatory bowel diseases based on the International Classification of Functioning, Disability, and Health. Inflamm Bowel Dis. 2010;16:15–22.

    Article  PubMed  Google Scholar 

  21. Williet N, Sandborn WJ, Peyrin-Biroulet L. Patient-reported outcomes as primary endpoints in clinical trials of inflammatory bowel disease. Clin Gastroenterol Hepatol. 2014;12:1246–56.e6.

    Article  PubMed  Google Scholar 

  22. van der Valk ME, Mangen MJ, Leenders M, et al. Healthcare costs of inflammatory bowel disease have shifted from hospitalisation and surgery towards anti-TNFalpha therapy: results from the COIN study. Gut. 2014;63:72–9.

    Article  PubMed  Google Scholar 

  23. Gibson TB, Ng E, Ozminkowski RJ, et al. The direct and indirect cost burden of Crohn’s disease and ulcerative colitis. J Occup Environ Med. 2008;50:1261–72.

    Article  PubMed  Google Scholar 

  24. Stjernman H, Tysk C, Almer S, et al. Unfavourable outcome for women in a study of health-related quality of life, social factors and work disability in Crohn’s disease. Eur J Gastroenterol Hepatol. 2011;23:671–9.

    Article  PubMed  Google Scholar 

  25. van der Valk ME, Mangen MJ, Leenders M, et al. Risk factors of work disability in patients with inflammatory bowel disease—a Dutch nationwide web-based survey: work disability in inflammatory bowel disease. J Crohn’s Colitis. 2014;8:590–7. This study aimed to assess the prevalence of and predictive factors for work disability in CD and UC. Overall, CD patients suffered more frequently from work disability than UC patients. A combination of demographic and disease-related factors is predictive of work disability.

    Article  Google Scholar 

  26. Dias CC, Rodrigues PP, da Costa-Pereira A, et al. Clinical prognostic factors for disabling Crohn’s disease: a systematic review and meta-analysis. World J Gastroenterol. 2013;19:3866–71.

    Article  PubMed  PubMed Central  Google Scholar 

  27. Leong RW, Huang T, Ko Y, et al. Prospective validation study of the International classification of functioning, disability and health score in Crohn’s disease and ulcerative colitis. J Crohn’s Colitis. 2014. doi:10.1016/j.crohns.2014.02.028.

    Google Scholar 

  28. Boonen A, Dagnelie PC, Feleus A, et al. The impact of inflammatory bowel disease on labor force participation: results of a population sampled case–control study. Inflamm Bowel Dis. 2002;8:382–9.

    Article  PubMed  Google Scholar 

  29. Abraham BP, Sellin JH. Disability in inflammatory bowel disease. Gastroenterol Clin N Am. 2012;41:429–41.

    Article  Google Scholar 

  30. WHO. World Health Organization Disability Assessment Schedule (WHODAS). Geneva: World Health Organization; 2001.

  31. Vergara M, Montserrat A, Casellas F, et al. A new validation of the Spanish Work Productivity and Activity Impairment Questionnaire: Crohn’s disease version. Value Health. 2011;14:859–61.

    Article  PubMed  Google Scholar 

  32. Gibson PR, Vaizey C, Black CM, et al. Relationship between disease severity and quality of life and assessment of health care utilization and cost for ulcerative colitis in Australia: a cross-sectional, observational study. J Crohn’s Colitis. 2014;8:598–606.

    Article  Google Scholar 

Download references

Compliance with Ethics Guidelines

Conflict of Interest

Katharina Büsch is a registered PhD student at Karolinska Institutet and an employee of AbbVie AB. Katharina Büsch holds stocks in AbbVie. Dr. Sonnenberg has nothing to disclose. Dr. Bansback has worked on projects funded by AbbVie and received grants from Pfizer for postdoctoral projects unrelated to this paper. No funding or writing assistance was provided for this project.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the author.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Katharina Büsch.

Additional information

This article is part of the Topical Collection on Inflammatory Bowel Disease

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Büsch, K., Sonnenberg, A. & Bansback, N. Impact of Inflammatory Bowel Disease on Disability. Curr Gastroenterol Rep 16, 414 (2014). https://doi.org/10.1007/s11894-014-0414-0

Download citation

  • Published:

  • DOI: https://doi.org/10.1007/s11894-014-0414-0

Keywords

Navigation