Centre for Neuroscience, Surgery and Trauma, Wingate Institute of Neurogastroenterology, Barts and The London School of Medicine and Dentistry, University of London, London, UK.
Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan.
Neurogastroenterol Motil. 2024 Oct;36(10):e14881. doi: 10.1111/nmo.14881. Epub 2024 Jul 30.
Patients (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.
Online 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.
A 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 & INFERENCES: Differences 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.
有 20%-50%的炎症性肠病（IBD）患者在缓解期会出现慢性腹痛。缓解期 IBD 患者腹痛的临床特征仍未得到很好的描述。本横断面研究旨在评估患者招募、依从性和反馈情况，以优化未来使用的问卷，并确定区分缓解期伴或不伴腹痛的 IBD 患者的临床特征。
向英国国家卫生与保健研究所（NIHR）IBD 生物资源的参与者发送了关于疾病活动、症状和心理因素的在线验证问卷，该资源是一个由可召回的 IBD 患者组成的全国性研究平台，旨在加速对克罗恩病和结肠炎的研究。应用了 IBD 生物资源主要队列的纳入/排除标准。对缓解期的参与者进行描述性和推断性统计分析。p 值≤0.01 被认为具有统计学意义。
共向 2050 名患者发出邀请，其中 291 名（14.2%）表示同意参加。在 35 名患者中，技术问题、问卷长度和对某些问卷相关性的理解较差，这在反馈中得到了证实，影响了完成情况。共有 244 名患者为完全应答者，其中 122 名（50%）处于缓解期；其中 33 名（27%）有慢性腹痛。与无慢性腹痛（n=89）的患者相比，有慢性腹痛的患者在以下方面的评分更高：躯体化（p<0.001）；胃肠道症状评分量表评分（p<0.001）；高度敏感量表（p=0.007）；灾难化评分（p=0.010）。阿扎胞苷使用率（p=0.021）；一般健康的应对资源量表（p=0.046）；神经质（p=0.019）；睡眠质量差（p=0.03）也存在趋势。
缓解期伴或不伴腹痛的 IBD 患者在症状和心理特征方面存在差异。在更大规模的研究中证实这些发现，可能有助于为 IBD 患者制定个性化的慢性疼痛治疗方案。
