1
|
Janssen LM, Rezazadeh Ardabili A, Romberg-Camps MJL, Winkens B, van den Broek RJ, Hulst J, Verwijs HJA, Keszthelyi D, Jonkers DMAE, van Bodegraven AA, Pierik MJ, Mujagic Z. Abdominal pain in patients with inflammatory bowel disease in remission: A prospective study on contributing factors. Aliment Pharmacol Ther 2023; 58:1041-1051. [PMID: 37724651 DOI: 10.1111/apt.17718] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 07/10/2023] [Accepted: 08/29/2023] [Indexed: 09/21/2023]
Abstract
BACKGROUND Abdominal pain is highly prevalent in patients with inflammatory bowel disease (IBD) in remission, but the aetiology is incompletely understood. AIM To investigate the association of clinical, lifestyle and psychosocial factors with abdominal pain in patients with IBD in remission. METHODS We performed a prospective multicentre study enrolling consecutive patients with IBD. Data were collected between 1 January 2020 and 1 July 2021, using myIBDcoach, an established remote monitoring platform for IBD. Chronic abdominal pain in IBD in remission (IBDremissionPain+) was defined as abdominal pain score ≥3 (0-10 NRS) on ≥1/3 of all assessments, combined with faecal calprotectin <150 μg/g in 90 days around periodic assessments. Disease activity, lifestyle and psychosocial factors were assessed every 1-3 months during 18 months. Using linear mixed models, the association of these factors with abdominal pain over time was analysed. RESULTS We included 559 patients, of whom 429 (76.7%) remained in biochemical remission. Of these, 198 (46.2%) fulfilled the criteria for chronic abdominal pain. IBDremissionPain+ patients were characterised by female sex, younger age, higher BMI, and shorter disease duration. They reported more often or higher levels of stress, fatigue, depressive and anxiety symptoms, and life events (all p < 0.001). In the multivariable analysis, sex, disease entity, fatigue, depressive symptoms and life events were associated with abdominal pain over time (all p < 0.05). CONCLUSION In this cohort of patients with IBD in remission, abdominal pain was common and associated with psychosocial factors. A more holistic treatment approach for patients with IBD suffering from abdominal pain may improve quality of care and subjective wellbeing.
Collapse
Affiliation(s)
- L M Janssen
- Department of Internal Medicine-, Division of Gastroenterology and Hepatology, Maastricht University Medical Centre+, Maastricht, The Netherlands
- School for Nutrition and Translational Research in Metabolism NUTRIM, Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - A Rezazadeh Ardabili
- Department of Internal Medicine-, Division of Gastroenterology and Hepatology, Maastricht University Medical Centre+, Maastricht, The Netherlands
- School for Nutrition and Translational Research in Metabolism NUTRIM, Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - M J L Romberg-Camps
- Department of Gastroenterology- Geriatrics- Internal and Intensive Care Medicine Co-MIK, Zuyderland Medical Centre, Heerlen-Sittard-Geleen, The Netherlands
| | - B Winkens
- Department of Methodology and Statistics, Maastricht University Medical Centre+, Maastricht, The Netherlands
- Care and Public Health Research Institute CAPHRI, Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - R J van den Broek
- Department of Internal Medicine-, Division of Gastroenterology and Hepatology, Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - J Hulst
- Department of Internal Medicine-, Division of Gastroenterology and Hepatology, Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - H J A Verwijs
- Department of Internal Medicine-, Division of Gastroenterology and Hepatology, Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - D Keszthelyi
- Department of Internal Medicine-, Division of Gastroenterology and Hepatology, Maastricht University Medical Centre+, Maastricht, The Netherlands
- School for Nutrition and Translational Research in Metabolism NUTRIM, Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - D M A E Jonkers
- Department of Internal Medicine-, Division of Gastroenterology and Hepatology, Maastricht University Medical Centre+, Maastricht, The Netherlands
- School for Nutrition and Translational Research in Metabolism NUTRIM, Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - A A van Bodegraven
- Department of Gastroenterology- Geriatrics- Internal and Intensive Care Medicine Co-MIK, Zuyderland Medical Centre, Heerlen-Sittard-Geleen, The Netherlands
| | - M J Pierik
- Department of Internal Medicine-, Division of Gastroenterology and Hepatology, Maastricht University Medical Centre+, Maastricht, The Netherlands
- School for Nutrition and Translational Research in Metabolism NUTRIM, Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - Z Mujagic
- Department of Internal Medicine-, Division of Gastroenterology and Hepatology, Maastricht University Medical Centre+, Maastricht, The Netherlands
- School for Nutrition and Translational Research in Metabolism NUTRIM, Maastricht University Medical Centre+, Maastricht, The Netherlands
| |
Collapse
|