Abstract
Background Inflammatory bowel disease (IBD), encompassing Crohn's disease (CD) and ulcerative colitis (UC), is a chronic immune-mediated disorder that often emerges in early adulthood, coinciding with peak occupational years. Despite therapeutic progress, IBD continues to impair health-related quality of life (HRQoL) and work capacity. This study aimed to assess its impact on quality of life and work productivity compared with healthy controls. Methodology This cross-sectional, observational study included 371 patients with IBD (CD: 59.8%; UC: 40.2%) and 371 age- and gender-matched healthy controls, recruited from two tertiary hospitals. Clinical, endoscopic, and demographic data were collected, including disease duration, treatment regimen, disease activity, and the presence of extraintestinal manifestations. HRQoL was assessed using the EuroQol 5 Dimensions 3 Levels (EQ-5D-3L), and work productivity was assessed using the Work Productivity and Activity Impairment (WPAI) questionnaire. Predictive models were implemented using categorical regression with optimal scaling. Results Across all dimensions of the EQ-5D-3L and WPAI, patients with IBD reported greater impairment than healthy controls (p < 0.001). Multivariable models identified physically demanding occupation as the strongest predictor of impaired patient-reported outcomes, with extraintestinal manifestations, age, gender, and disease duration contributing variably across domains (all p < 0.05). CD was independently associated with limitations in usual activities (p = 0.007). Both the Harvey-Bradshaw Index (p < 0.001) and Partial Mayo Score (p < 0.001) correlated negatively with health state and activity impairment. Conclusions IBD patients under treatment continue to experience significant impairments in HRQoL and work productivity compared with healthy controls. Physically demanding occupation, extraintestinal manifestations, and CD emerged as key determinants of impaired outcomes in IBD, highlighting the need for integrated management strategies addressing occupational and systemic disease burden.