Lifestyle restrictions are associated with impaired quality of life but not reduction in relapse in ulcerative colitis.
Journal
Intestinal research
Journal Volume
24
Journal Issue
2
Start Page
225
End Page
235
ISSN
1598-9100
Date Issued
2026-04
Author(s)
Yamazaki, Hajime
Nagahori, Masakazu
Hisamatsu, Tadakazu
Kobayashi, Taku
Omori, Teppei
Limdi, Jimmy K
McLaughlin, John T
Fernandez, Jovelle
Fukuhara, Shunichi
Matsuoka, Katsuyoshi
Abstract
Background/Aims: Patients with ulcerative colitis (UC) in remission commonly restrict thir lifestyle to prevent relapse; however, the effectiveness and impact on quality of life (QOL) is unclear. This study investigated whether lifestyle restrictions are associated with relapse reduction and assessed their impact on QOL. Methods: This multicenter, prospective cohort study was conducted in Japan (2018–2021) via the YOURS registry, enrolling patients with UC in clinical remission. Patients were followed for 2 years. A baseline questionnaire evaluated lifestyle restrictions in diet, work/study/housework, and physical exercise. QOL was assessed by Disease Impact Scale every 3 months during the first year of follow-up. Associations of lifestyle restrictions with relapse and QOL were assessed by Cox regression analysis and linear mixed-effects models, respectively. Results: Among 911 patients in clinical remission for >90 days, 63% had adopted dietary avoidance; 47%, work/study/housework avoidance; and 8%, physical exercise avoidance. Overall, 216 patients relapsed. Lifestyle restrictions were not associated with reduced risk of relapse (multivariable-adjusted hazard ratios [95% confidence interval]: dietary avoidance, 1.08 [0.81–1.44]; and work/study/housework avoidance, 1.14 [0.87–1.50]); physical exercise avoidance was associated with increased relapse (multivariable-adjusted hazard ratio, 1.58; 95% confidence interval, 1.02–2.44). All lifestyle restrictions were associated with impaired QOL (P<0.01). Conclusions: Lifestyle restrictions were not associated with relapse reduction in patients with UC; however, they were associated with impaired QOL. Clinicians should engage in evidence-based discussions with patients with UC in remission regarding lifestyle restrictions (UMIN Clinical Trials Registry; UMIN000031995).
Subjects
Lifestyle restriction
Quality of life
Relapse
Ulcerative colitis
Type
journal article