Colectomy fails to ease ulcerative colitis sick leave burden

Patients with ulcerative colitis (UC) take more time off work than the general population, even after undergoing colectomy, shows a large Swedish study.

Furthermore, in study patients who underwent colectomy, postoperative work loss did not return to pre-surgery rates.

The study, published in Gastroenterology, included 19,714 patients with UC during 2005, 16% of whom were colectomized. Patients who underwent colectomy between 1998 and 2002 were followed up for work loss for at least 3 years before and after surgery.

In total, 33% of UC patients had a registered sick leave episode or claimed disability pension during 2005 compared with 22% in the general population during 2005. There was also a significant association between the presence of UC and the number of work days lost, with adjusted analyses showing that UC patients lost 20 more days of work than the general population during the year.

Absence rates for colectomized UC patients were even higher, with 43% of these patients having at least one sick leave episode during 2005.

And, in patients who were followed up before and after colectomy, the mean annual work days lost increased from 58 in the year prior to colectomy to 112 the year after. Furthermore, when followed over the long term, 12.4% of colectomy patients were fully work disabled 3 years after surgery, compared with 5.9% 3 years before. This compares with a rate of 7.2% in the general population.

However, the authors highlight that more than 50% of patients did not experience any work loss in the 3 years before or after colectomy.

They say that their findings are unsurprising given the relapsing nature of the disease and the potential need for hospitalization and surgery.

"For many UC patients, keeping a job may depend on close access to a toilet, and patients with stomas or pouches might face additional practical obstacles," explain Martin Neovius (Karolinska Institute, Stockholm, Sweden) and colleagues.

"Furthermore, major surgery such as colectomy may have social as well as psychological consequences, both of which may increase work loss."

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