Journal des maladies et troubles inflammatoires de l'intestin

Genetic and Demographic Correlates of Quality of Life after Ileal Pouch Anal Anastomosis for Ulcerative Colitis

Abstract

Tara M Connelly, Bailey Sanders, Arthur S Berg, Emmanuelle Williams, Leonard Harris III, Andrew Tinsley, Walter A Koltun

Objective: Patient satisfaction after ileal pouch anal anastomosis (IPAA) for ulcerative colitis (UC) is difficult to predict preoperatively and has never been investigated from a genetic perspective. Methods: Modified IBD quality of life (QOL) questionnaires were mailed to all UC-IPAA patients in our IBD Biobank. Genotyping was performed using a custom microarray containing 325 IBD-associated single nucleotide polymorphisms (SNPs). Fisher's exact and Mann-Whitney tests and logistic regression with the Bonferroni correction were used for analysis. Results: Response rate was 69% (142 of 206 patients, mean pouch duration=10.1 ± 0.5years). Patients diagnosed at a younger age and with shorter time to colectomy reported poorer emotional wellbeing scores. Readmission post-colectomy was significantly associated with poor overall and emotional scores. On multivariate analysis, female gender and readmission were predictors of poor overall QOL. Poorer emotional wellbeing and systemic symptom scores were found in patients who had undergone colectomy urgently. Smoking history correlated with poor bowel and social scores. SNP rs2279627 associated with the immunoregulatory TNFSF14 gene and two POU5F1/OCT4 gene related SNPs, rs7837328 and rs7014346, were significantly associated with poorer emotional wellbeing scores. Rs2279627 was also significantly associated with poorer scores in the overall and bowel symptom categories. Conclusions: 1) Female gender, short