Tse Chung Sang, Hunt Melissa G, Brown Lily A, Lewis James D
Division of Gastroenterology, University of Pennsylvania, Philadelphia, PA, USA.
Department of Psychology, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Inflamm Bowel Dis. 2024 Mar 1;30(3):501-507. doi: 10.1093/ibd/izad182.
The diagnosis of inflammatory bowel disease (IBD) is a life-changing moment for most adults. Biomedical advances over the past 2 decades have resulted in unprecedented growth of therapeutic options for IBD. However, due to the incurable nature of IBD, medical and surgical intervention alone may not be adequate to completely normalize health status and prevent long-term disability. In the biopsychosocial model of health and disease, a person's health and function result from complex physical, psychosocial, and environmental interactions. Adapting the World Health Organization definition, IBD-related disability encompasses limitations in educational and employment opportunities, exclusions in economic and social activities, and impairments in physical and psychosocial function. Although the concept of IBD-related disability is a long-term treatment end point in the updated Selecting Therapeutic Targets in Inflammatory Bowel Disease (STRIDE-II) treatment guideline, it has received limited attention in the literature. This review article explores an etiological framework of the physical and psychosocial aspects that contribute to IBD-related disability. We also explore the impact of IBD-related disability on the direct and indirect costs of IBD. Lastly, we present the available evidence for interventions with the potential to improve function and reduce IBD-related disability.
对大多数成年人来说,炎症性肠病(IBD)的诊断是一个改变人生的时刻。过去20年里的生物医学进展使IBD的治疗选择得到了前所未有的增长。然而,由于IBD无法治愈,仅靠药物和手术干预可能不足以使健康状况完全恢复正常并预防长期残疾。在健康与疾病的生物心理社会模型中,一个人的健康和功能源于复杂的身体、心理社会和环境相互作用。根据世界卫生组织的定义改编,IBD相关残疾包括教育和就业机会受限、被排除在经济和社会活动之外以及身体和心理社会功能受损。尽管IBD相关残疾的概念是更新后的《炎症性肠病治疗靶点选择(STRIDE-II)》治疗指南中的一个长期治疗终点,但在文献中受到的关注有限。这篇综述文章探讨了导致IBD相关残疾的身体和心理社会方面的病因框架。我们还探讨了IBD相关残疾对IBD直接和间接成本的影响。最后,我们介绍了有助于改善功能和减少IBD相关残疾的干预措施的现有证据。