Background: Ulcerative colitis (UC) is a lifelong systemic multifactorial disease with a negative impact on health-related quality of life (HRQoL). Restless Legs Syndrome (RLS) as an extraintestinal manifestation of UC is not very common. This association has been investigated in a small number of studies but results remain controversial. The primary aim of the current study was to investigate the prevalence and association between RLS and UC.
Methods: 120 subjects (man/female: 67/53, age at diagnosis: 39.3 years, SD: 16.2) with biopsy confirmed UC and 120 age and gender matched controls were included in this prospective single-center study. All patients with diabetes, peripheral neuropathy, renal failure and those who underwent treatment with antipsychotic drugs and antidepressants that increase serotonin were excluded from the study. Basic demographic data, clinical information and laboratory findings were collected and comprehensively reviewed. All subjects were prospectively evaluated using the International Restless Legs Syndrome Study Group criteria (IRLSSG). The IRLSSG ten-item severity scale was also used. Gender, age at diagnosis, family history, occupation, smoking status, caffeine intake, BMI, iron, vitamine B12, folate and hemoglobin levels were analyzed as potential impact factors.
Results: Based on our findings, the prevalence of RLS in UC patients is 24.1% compared with 5% in the control group (p=0.001). Symptom severity in the RLS group (according to the IRLSSG rating scale) was mild in 4 patients (13.7%), moderate in 10 patients (34.4%), severe in 13 patients (44.8%) and very severe in 2 patients (5.8%). In a multivariate analysis performed by binary logistic regression, elderly onset UC (age at diagnosis >60 years), BMI ≥30kg/m2 and caffeine intake were the strongest predictors of RLS in patients with UC. There was no significant correlation between RLS and occupation, iron, folate, hemoglobin and vitamin B12 levels. RLS was significantly correlated with sleep disorders (86.2%), fatigue (60.9%) and anxiety (31.03%) in patients with UC (p<0.001).
Conclusions: Our study demonstrates that RLS is rather common in patients with UC. The results of our research are limited by the small number of patients enrolled in the study. Further investigations are needed to confirm RLS as an extraintestinal manifestation of UC.