van Gils Tom, Törnblom Hans, Hreinsson Jóhann P, Jonefjäll Börje, Strid Hans, Simrén Magnus
Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Department of Medicine, Sahlgrenska University Hospital, Mölndal, Sweden.
Aliment Pharmacol Ther. 2025 Jan;61(2):268-277. doi: 10.1111/apt.18344. Epub 2024 Oct 23.
Abdominal pain can be an overlooked symptom in patients with ulcerative colitis (UC).
The aim of this study was to investigate the prevalence and factors associated with abdominal pain in active and quiescent UC.
Three study cohorts of adult UC patients were used. Cross-sectional cohorts I and II included 130 (46 active) and 288 (156 active) patients. Longitudinal cohort III included 83 patients with active disease at diagnosis that reached deep remission during follow-up. The Gastrointestinal Symptom Rating Scale was used to assess abdominal pain and other validated questionnaires to assess psychological distress, fatigue and quality of life (QoL).
In the two cross-sectional cohorts, 63% and 58% of the active vs. 54% and 33% of the quiescent UC patients reported abdominal pain (both p ≤ 0.02). In the longitudinal cohort, 71% had abdominal pain at diagnosis vs. 46% when in remission (p < 0.001). In multivariable models, symptoms of anxiety were associated with higher abdominal pain levels in both cross-sectional cohorts (OR 1.75 [IQR 1.11-2.76] and OR 1.99 [1.45-2.73]), whereas in cohort II, active disease (OR 2.68 [1.61-4.45]) and female sex (OR 2.03 [1.21-3.41]) were also associated with pain. QoL was negatively correlated with higher levels of abdominal pain, both in active and quiescent disease.
Abdominal pain in UC is prevalent and associated with lower QoL in both active and quiescent disease. Associated factors are active disease, female sex and psychological symptoms, especially anxiety. We suggest considering a holistic approach when treating UC patients with abdominal pain.
腹痛在溃疡性结肠炎（UC）患者中可能是一个被忽视的症状。
本研究旨在调查活动期和缓解期UC患者腹痛的患病率及相关因素。
使用了三个成年UC患者研究队列。横断面队列I和II分别包括130例（46例活动期）和288例（156例活动期）患者。纵向队列III包括83例诊断时患有活动期疾病且在随访期间达到深度缓解的患者。使用胃肠道症状评定量表评估腹痛，并使用其他经过验证的问卷评估心理困扰、疲劳和生活质量（QoL）。
在两个横断面队列中，活动期UC患者分别有63%和58%报告有腹痛，而缓解期UC患者分别为54%和33%（均p≤0.02）。在纵向队列中，诊断时71%的患者有腹痛，缓解期为46%（p<0.001）。在多变量模型中，焦虑症状在两个横断面队列中均与较高的腹痛水平相关（OR 1.75 [IQR 1.11 - 2.76]和OR 1.99 [1.45 - 2.73]），而在队列II中，活动期疾病（OR 2.68 [1.61 - 4.45]）和女性（OR 2.03 [1.21 - 3.41]）也与疼痛相关。无论是活动期还是缓解期疾病，QoL均与较高水平的腹痛呈负相关。
UC患者的腹痛很常见，并且在活动期和缓解期疾病中均与较低的QoL相关。相关因素包括活动期疾病、女性和心理症状，尤其是焦虑。我们建议在治疗有腹痛的UC患者时考虑采用整体方法。
