Disability and need for rehabilitation among patients with inflammatory bowel disease.

Physicians who manage patients with inflammatory bowel disease (IBD) as well as the patients themselves need to know about the prospects of disability and the demand for rehabilitation associated with this chronic disease. The present study uses German social security statistics to characterize IBD patients undergoing a rehabilitation or having a disability and their employment status before and after rehabilitation. Each year, about 9 and 3% of all German employees with IBD underwent a rehabilitation or were granted a disability pension, respectively. In comparison with other diseases, IBD patients tended to be young, female and employed in white-collar occupations. Although they had significantly longer sick leaves, 87% were still employed before entering rehabilitation. The majority, i.e. 72%, improved under rehabilitation. Compared with other diseases, however, rehabilitation of patients with IBD was less successful, i.e. less patients improved, and more patients remained unchanged or even worsened during rehabilitation. After rehabilitation, continuation of the last employment was recommended in 82% of the cases, in 94% after additional medical or vocational measures. Overall, failed rehabilitation led to a similar rate of disability in IBD as in other diseases. Within the IBD population, however, female sex and white-collar occupations were associated with an increased risk, while male sex and blue-collar occupations were associated with a reduced risk for disability. These data reflect the underlying epidemiology of IBD as well as its natural history. Despite its severity and chronicity, the overwhelming majority of patients with IBD manage to stay in the work force and succeed in overcoming the obstacles posed by their disease.