Factors associated with chronic abdominal pain in patients with inflammatory bowel disease in remission: A pilot cross‐sectional study

Author:

Engelmann‐Kewitz Maike1,Khwaja Iman1,Takahashi Kazuya12,Parkes Miles3,Norton Christine4,Hart Ailsa5,Bulmer David6,Aziz Qasim1

Affiliation:

1. Centre for Neuroscience, Surgery and Trauma, Wingate Institute of Neurogastroenterology, Barts and The London School of Medicine and Dentistry University of London London UK

2. Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences Niigata University Niigata Japan

3. Department of Gastroenterology, Addenbrooke's Hospital Cambridge University Hospitals Cambridge UK

4. Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care King's College London London UK

5. Department of Metabolism, Digestion and Reproduction, Faculty of Medicine St Marks Hospital London UK

6. Department of Pharmacology University of Cambridge Cambridge UK

Abstract

AbstractBackgroundPatients (20%–50%) with inflammatory bowel disease (IBD) experience chronic abdominal pain during remission. The clinical features of IBD patients with abdominal pain during remission remain poorly characterized. This cross‐sectional pilot study aimed to assess patient recruitment, adherence, and feedback to optimize questionnaires for future use and to determine the clinical features that distinguish IBD patients in remission with and without abdominal pain.MethodsOnline validated questionnaires about disease activity, symptoms, and psychological factors were sent to participants of the UK National Institute for Health and Care Research (NIHR) IBD BioResource, which is a national research platform consisting of re‐callable IBD patients designed to expedite research into Crohn's and colitis. Inclusion/exclusion criteria of the IBD BioResource main cohort were applied. Descriptive and inferential statistics were applied to participants in remission. p‐values ≤0.01 were considered significant.Key resultsA total of 2050 patients were approached; 291 (14.2%) of these agreed to participate. In 35 patients, technical problems, length, and poor understanding of the relevance of some questionnaires affected completion as confirmed by feedback. In total, 244 patients were full responders with 122 (50%) in remission; 33 (27%) of these had chronic abdominal pain. Comparison of those with versus without (n = 89) chronic abdominal pain yielded higher scores in patients with pain for the following: somatization (p < 0.001); gastrointestinal symptoms rating scale score (p = <0.001); highly sensitive person scale (p = 0.007); catastrophizing score (p = 0.010). Trends were observed for azathioprine use (p = 0.021); coping resources inventory health in general (p = 0.046); neuroticism (p = 0.019); and poor sleep (p = 0.03).Conclusions & inferencesDifferences in symptoms and psychological characteristics exist between IBD patients in remission with and without abdominal pain. Confirmation of findings in larger studies may facilitate development of personalized chronic pain treatments for IBD patients.

Publisher

Wiley

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