TOPLINE:

Patients with inflammatory bowel disease (IBD) reported poorer health-related quality of life (HRQOL) than healthy individuals despite high remission rates, with alterations in gut microbiota more strongly linked to HRQOL than disease activity.

METHODOLOGY:

• Gut dysbiosis is common in IBD, yet its association with HRQOL remains uncertain, and specific oral and fecal microbial features linked to impaired HRQOL have not been well-defined.
• Australian researchers performed a cross-sectional analysis of adults with ulcerative colitis or Crohn’s disease and healthy control individuals recruited between June 2019 and November 2023.
• HRQOL was measured using the 36-item Short-Form Health Survey (SF-36; physical and mental component summary scores). IBD-specific HRQOL was measured with the 32-item IBD Questionnaire (IBDQ-32), which was classified as impaired IBD-HRQOL (score < 170) or preserved IBD-HRQOL (score ≥ 170).
• Oral and fecal microbiota were profiled using 16S rRNA sequencing, with alpha and beta diversity calculated from these datasets.

TAKEAWAY:

• Among 751 participants (mean age, 43.3 years; 56% women), 232 had Crohn’s disease, 214 had ulcerative colitis, and 305 were healthy individuals.
• Compared with healthy individuals, patients with IBD had lower SF-36 physical (51.6 vs 55.7; P <.0001) and mental (45.1 vs 52.2; P < .001) component scores. IBDQ-32 indicated impaired IBD-HRQOL in 42% of patients with Crohn’s disease and 41% of those with ulcerative colitis, despite low rates of clinical or biochemical activity.
• Impaired IBD-HRQOL vs preserved IBD-HRQOL was associated with lower alpha diversity (Chao1, 155.2 vs 172.4; P = .015) and distinct beta diversity (R², 0.003; P = .019) vs preserved IBD-HRQOL.
• Overall, 62 fecal genera and 33-34 oral genera were associated with at least one HRQOL measure in both ulcerative colitis and Crohn’s disease. These genus-level associations with HRQOL were stronger than associations with clinical or biochemical activity.

IN PRACTICE:

“These findings may suggest the capacity for gut microbes to mediate an extra-intestinal burden of disease in IBD patients. If so, targeted microbial manipulation may introduce a novel, therapeutic avenue to improve HRQOL in IBD beyond existing immunosuppressive therapies,” the authors wrote.

SOURCE:

This study was led by Little RD and Tharusha Jayawardana, University of New South Wales, Sydney, Australia. It was published online in The American Journal of Gastroenterology.

LIMITATIONS:

The use of 16S rRNA sequencing limited the microbial identification to the genus level. Most participants were in biochemical remission, potentially weakening associations between disease activity and microbial diversity. Diet, physical activity, and medication adherence were not captured and could influence both HRQOL and microbial diversity.

DISCLOSURES:

Several authors reported receiving grants, advisory board participation fees, speaker fees, educational support, research support, and other financial ties with various pharmaceutical and healthcare companies, including Dr. Falk Pharma, Celltrion Healthcare, and AbbVie.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.