Beames Charlotte, Azadi Afra, Williams Amanda C de C
Research Department of Clinical, Educational and Health Psychology, University College London, London, UK.
Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
BMJ Open Gastroenterol. 2025 Sep 5;12(1):e001866. doi: 10.1136/bmjgast-2025-001866.
People with inflammatory bowel disease (IBD) commonly experience pain, whether during active disease or remission, which interferes with daily life and major goals and causes distress. Current psychological methods of pain management draw from musculoskeletal pain interventions, but it has not been established that the musculoskeletal model is a good fit. We aimed to outline a psychological model of IBD pain.
We used qualitative methods: a very open interview (Grid Elaboration Method), conducted online and transcripts analysed for themes and subthemes. 15 men and 15 women with IBD pain, recruited from a national charity, took part in 4 months to February 2024. Participants scored their average pain 5/10 and interference by pain with activity 6/10, where 10 is maximum pain or interference.
We extracted five inter-related themes: on the emotional impact of pain and symptoms; the challenge of pain; restrictions due to pain and other IBD symptoms; shortcomings in healthcare, particularly for pain; and poor public understanding of IBD. Although the first theme, universally endorsed, covered anxiety about the meaning of pain, we did not find the fears about physical integrity that characterise much musculoskeletal pain, nor the avoidance of physical activities based on those fears.
We propose that further exploration is warranted of the experience of IBD-related pain and how people adjust to it. This will inform the design of better psychologically-informed interventions to help people with IBD manage their pain, independently and in partnership with healthcare.
炎症性肠病（IBD）患者无论在疾病活动期还是缓解期都常经历疼痛，这会干扰日常生活和主要目标并导致痛苦。当前疼痛管理的心理方法借鉴了肌肉骨骼疼痛干预措施，但尚未确定肌肉骨骼模型是否适用。我们旨在概述IBD疼痛的心理模型。
我们采用定性方法：通过在线进行非常开放的访谈（网格细化法），并对访谈记录进行主题和子主题分析。从一家全国性慈善机构招募了15名患有IBD疼痛的男性和15名女性，参与时间截至2024年2月，为期4个月。参与者对其平均疼痛程度评分为5/10，疼痛对活动的干扰评分为6/10，其中10表示最大疼痛或干扰程度。
我们提取了五个相互关联的主题：疼痛和症状的情感影响；疼痛的挑战；因疼痛和其他IBD症状导致的限制；医疗保健方面的不足，尤其是疼痛治疗方面；以及公众对IBD的了解不足。尽管第一个主题得到普遍认可，涵盖了对疼痛含义的焦虑，但我们并未发现肌肉骨骼疼痛常见的对身体完整性的恐惧，也未发现基于这些恐惧而避免身体活动的情况。
我们建议有必要进一步探索IBD相关疼痛的体验以及人们如何适应它。这将为设计更好的心理干预措施提供依据，以帮助IBD患者独立或与医疗保健人员合作管理疼痛。
