Dig Dis Sci. 2026 Feb 16. doi: 10.1007/s10620-026-09766-0. Online ahead of print.
ABSTRACT
PURPOSE: To evaluate the impact of perianal Crohn’s disease (PCD) activity on quality of life (QoL), fecal continence, and sexual function in patients with Crohn’s disease (CD), and to identify factors associated with impaired patient-reported outcomes.
METHODS: A cross-sectional analytical study was conducted, from an existing database of patients with CD at Shaare Zedek Medical Center who diagnosed with and without perianal disease and were seen in IBD clinic between June 2023 and August 2024. The patients agreed to participate and answered validated questionnaires that assessed QoL (SIBDQ), fecal incontinence (WEXNER), and sexual function (IIEF for men, FSFI for women).
RESULTS: A total of 150 patients with CD were recruited, including 47 with PCD (active and non-active) and 103 without PCD. Patients with active PCD had significantly lower QoL compared to those with non-active PCD and without PCD (p = 0.001). Two major risk factors for decreased QoL were identified: age over 40 (p = 0.024) and only conservative treatment (without chronic medication) (p = 0.031). Although no significant difference was found in fecal incontinence between groups, 64.2% of patients with CD reported some degree of incontinence. Sexual function scores were lower in patients with CD, particularly women, though the difference was not statistically significant.
CONCLUSION: Active PCD significantly reduces QoL in patients with CD, with older age and absence of chronic treatment contributing to poorer outcomes. These findings highlight the need for optimized treatment strategies to improve patient well-being. Further research should explore additional clinical and psychological aspects affecting patients with CD with perianal involvement.
KEY MESSAGES: What is already known? Perianal Crohn’s disease is a severe phenotype linked to high morbidity and healthcare use. Its impact on quality of life is known, but the roles of disease activity, incontinence, and sexual function remain unclear. What is new here? Active perianal disease significantly worsens quality of life, unlike inactive disease. Older age and lack of maintenance therapy further reduce patient-reported outcomes. How can this study help patient care? Distinguishing active from inactive disease is crucial. Early detection, ongoing therapy, and structured assessment of continence and sexual health can improve quality of life.
PMID:41697513 | DOI:10.1007/s10620-026-09766-0
