Abdominal pain in ulcerative colitis

Matthew D. Coates, Mayank Lahoti, David G. Binion, Eva M. Szigethy, Miguel D. Regueiro, Klaus Bielefeldt

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

Background: Chronic pain is common in patients with inflammatory bowel disease and often attributed to inflammation. However, many patients with inflammatory bowel disease without evidence of active disease continue to experience pain. This study was undertaken to determine the prevalence of pain in patients with ulcerative colitis (UC) and examine the role of inflammation and psychiatric comorbidities in patients with UC with pain. Methods: We performed a retrospective cross-sectional analysis of adult patients with UC seen at a tertiary referral inflammatory bowel disease center. Age, gender, disease duration and extent, abdominal pain rating, quality of life, physician global assessment, endoscopic and histological rating of disease severity, C reactive protein, and erythrocyte sedimentation rate were abstracted. Results: A total of 1268 patients were identified using billing codes for colitis. Five hundred and two patients (48.2% women) met all inclusion criteria. Two hundred and sixty-two individuals (52.2%) complained of abdominal pain, with 108 individuals (21.5%) describing more frequent pain ("some of the time or more"). Of those with quiescent disease (n = 326), 33 patients (10%) complained of more frequent pain. Physician global assessment, endoscopic and histological severity rating, erythrocyte sedimentation rate, and C reactive protein significantly correlated with pain ratings. The best predictors of pain were physician global assessment, C reactive protein and erythrocyte sedimentation rate, female gender, and coexisting mood disorders. Conclusions: Abdominal pain affects more than 50% of patients with UC. Although inflammation is important, the skewed gender distribution and correlation with mood disorders highlight parallels with functional bowel disorders and suggest a significant role for central mechanisms. Management strategies should thus go beyond a focus on inflammation and also include interventions that target psychological mechanisms of pain.

Original languageEnglish (US)
Pages (from-to)2207-2214
Number of pages8
JournalInflammatory bowel diseases
Volume19
Issue number10
DOIs
StatePublished - Sep 1 2013

Fingerprint

Ulcerative Colitis
Abdominal Pain
Pain
Blood Sedimentation
Inflammatory Bowel Diseases
C-Reactive Protein
Inflammation
Physicians
Mood Disorders
Colitis
Chronic Pain
Psychiatry
Comorbidity
Referral and Consultation
Cross-Sectional Studies
Quality of Life
Psychology

All Science Journal Classification (ASJC) codes

  • Immunology and Allergy
  • Gastroenterology

Cite this

Coates, M. D., Lahoti, M., Binion, D. G., Szigethy, E. M., Regueiro, M. D., & Bielefeldt, K. (2013). Abdominal pain in ulcerative colitis. Inflammatory bowel diseases, 19(10), 2207-2214. https://doi.org/10.1097/MIB.0b013e31829614c6
Coates, Matthew D. ; Lahoti, Mayank ; Binion, David G. ; Szigethy, Eva M. ; Regueiro, Miguel D. ; Bielefeldt, Klaus. / Abdominal pain in ulcerative colitis. In: Inflammatory bowel diseases. 2013 ; Vol. 19, No. 10. pp. 2207-2214.
@article{5854603261b04fb7988c795505e9d3bd,
title = "Abdominal pain in ulcerative colitis",
abstract = "Background: Chronic pain is common in patients with inflammatory bowel disease and often attributed to inflammation. However, many patients with inflammatory bowel disease without evidence of active disease continue to experience pain. This study was undertaken to determine the prevalence of pain in patients with ulcerative colitis (UC) and examine the role of inflammation and psychiatric comorbidities in patients with UC with pain. Methods: We performed a retrospective cross-sectional analysis of adult patients with UC seen at a tertiary referral inflammatory bowel disease center. Age, gender, disease duration and extent, abdominal pain rating, quality of life, physician global assessment, endoscopic and histological rating of disease severity, C reactive protein, and erythrocyte sedimentation rate were abstracted. Results: A total of 1268 patients were identified using billing codes for colitis. Five hundred and two patients (48.2{\%} women) met all inclusion criteria. Two hundred and sixty-two individuals (52.2{\%}) complained of abdominal pain, with 108 individuals (21.5{\%}) describing more frequent pain ({"}some of the time or more{"}). Of those with quiescent disease (n = 326), 33 patients (10{\%}) complained of more frequent pain. Physician global assessment, endoscopic and histological severity rating, erythrocyte sedimentation rate, and C reactive protein significantly correlated with pain ratings. The best predictors of pain were physician global assessment, C reactive protein and erythrocyte sedimentation rate, female gender, and coexisting mood disorders. Conclusions: Abdominal pain affects more than 50{\%} of patients with UC. Although inflammation is important, the skewed gender distribution and correlation with mood disorders highlight parallels with functional bowel disorders and suggest a significant role for central mechanisms. Management strategies should thus go beyond a focus on inflammation and also include interventions that target psychological mechanisms of pain.",
author = "Coates, {Matthew D.} and Mayank Lahoti and Binion, {David G.} and Szigethy, {Eva M.} and Regueiro, {Miguel D.} and Klaus Bielefeldt",
year = "2013",
month = "9",
day = "1",
doi = "10.1097/MIB.0b013e31829614c6",
language = "English (US)",
volume = "19",
pages = "2207--2214",
journal = "Inflammatory Bowel Diseases",
issn = "1078-0998",
publisher = "John Wiley and Sons Inc.",
number = "10",

}

Coates, MD, Lahoti, M, Binion, DG, Szigethy, EM, Regueiro, MD & Bielefeldt, K 2013, 'Abdominal pain in ulcerative colitis', Inflammatory bowel diseases, vol. 19, no. 10, pp. 2207-2214. https://doi.org/10.1097/MIB.0b013e31829614c6

Abdominal pain in ulcerative colitis. / Coates, Matthew D.; Lahoti, Mayank; Binion, David G.; Szigethy, Eva M.; Regueiro, Miguel D.; Bielefeldt, Klaus.

In: Inflammatory bowel diseases, Vol. 19, No. 10, 01.09.2013, p. 2207-2214.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Abdominal pain in ulcerative colitis

AU - Coates, Matthew D.

AU - Lahoti, Mayank

AU - Binion, David G.

AU - Szigethy, Eva M.

AU - Regueiro, Miguel D.

AU - Bielefeldt, Klaus

PY - 2013/9/1

Y1 - 2013/9/1

N2 - Background: Chronic pain is common in patients with inflammatory bowel disease and often attributed to inflammation. However, many patients with inflammatory bowel disease without evidence of active disease continue to experience pain. This study was undertaken to determine the prevalence of pain in patients with ulcerative colitis (UC) and examine the role of inflammation and psychiatric comorbidities in patients with UC with pain. Methods: We performed a retrospective cross-sectional analysis of adult patients with UC seen at a tertiary referral inflammatory bowel disease center. Age, gender, disease duration and extent, abdominal pain rating, quality of life, physician global assessment, endoscopic and histological rating of disease severity, C reactive protein, and erythrocyte sedimentation rate were abstracted. Results: A total of 1268 patients were identified using billing codes for colitis. Five hundred and two patients (48.2% women) met all inclusion criteria. Two hundred and sixty-two individuals (52.2%) complained of abdominal pain, with 108 individuals (21.5%) describing more frequent pain ("some of the time or more"). Of those with quiescent disease (n = 326), 33 patients (10%) complained of more frequent pain. Physician global assessment, endoscopic and histological severity rating, erythrocyte sedimentation rate, and C reactive protein significantly correlated with pain ratings. The best predictors of pain were physician global assessment, C reactive protein and erythrocyte sedimentation rate, female gender, and coexisting mood disorders. Conclusions: Abdominal pain affects more than 50% of patients with UC. Although inflammation is important, the skewed gender distribution and correlation with mood disorders highlight parallels with functional bowel disorders and suggest a significant role for central mechanisms. Management strategies should thus go beyond a focus on inflammation and also include interventions that target psychological mechanisms of pain.

AB - Background: Chronic pain is common in patients with inflammatory bowel disease and often attributed to inflammation. However, many patients with inflammatory bowel disease without evidence of active disease continue to experience pain. This study was undertaken to determine the prevalence of pain in patients with ulcerative colitis (UC) and examine the role of inflammation and psychiatric comorbidities in patients with UC with pain. Methods: We performed a retrospective cross-sectional analysis of adult patients with UC seen at a tertiary referral inflammatory bowel disease center. Age, gender, disease duration and extent, abdominal pain rating, quality of life, physician global assessment, endoscopic and histological rating of disease severity, C reactive protein, and erythrocyte sedimentation rate were abstracted. Results: A total of 1268 patients were identified using billing codes for colitis. Five hundred and two patients (48.2% women) met all inclusion criteria. Two hundred and sixty-two individuals (52.2%) complained of abdominal pain, with 108 individuals (21.5%) describing more frequent pain ("some of the time or more"). Of those with quiescent disease (n = 326), 33 patients (10%) complained of more frequent pain. Physician global assessment, endoscopic and histological severity rating, erythrocyte sedimentation rate, and C reactive protein significantly correlated with pain ratings. The best predictors of pain were physician global assessment, C reactive protein and erythrocyte sedimentation rate, female gender, and coexisting mood disorders. Conclusions: Abdominal pain affects more than 50% of patients with UC. Although inflammation is important, the skewed gender distribution and correlation with mood disorders highlight parallels with functional bowel disorders and suggest a significant role for central mechanisms. Management strategies should thus go beyond a focus on inflammation and also include interventions that target psychological mechanisms of pain.

UR - http://www.scopus.com/inward/record.url?scp=84884558432&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84884558432&partnerID=8YFLogxK

U2 - 10.1097/MIB.0b013e31829614c6

DO - 10.1097/MIB.0b013e31829614c6

M3 - Article

C2 - 23929261

AN - SCOPUS:84884558432

VL - 19

SP - 2207

EP - 2214

JO - Inflammatory Bowel Diseases

JF - Inflammatory Bowel Diseases

SN - 1078-0998

IS - 10

ER -

Coates MD, Lahoti M, Binion DG, Szigethy EM, Regueiro MD, Bielefeldt K. Abdominal pain in ulcerative colitis. Inflammatory bowel diseases. 2013 Sep 1;19(10):2207-2214. https://doi.org/10.1097/MIB.0b013e31829614c6