P662 Pain in IBD patients: very frequent and frequently insufficiently taken into account
J. Zeitz*1, G. Rogler1, S. Müller-Mottet2, L. Biedermann1, N. Fournier3, P. Frei4, V. Pittet3, M. Fried1, S. Vavricka5
1University Hospital Zurich, Division of Gastroenterology & Hepatology, Zurich, Switzerland, 2University Hospital Zurich, Division of Pulmonology, Zurich, Switzerland, 3University of Lausanne, Institute of Social and Preventive Medicine, Lausanne, Switzerland, 4Seespital Horgen, Division of Gastroenterology, Horgen, Switzerland, 5Triemli Hospital, Division of Gastroenterology and Hepatology, Zurich, Switzerland
Abdominal pain is a common symptom related to inflammatory bowel disease (IBD) and appears to be present in about 50-70% of IBD patients. Other pain localizations can be caused by extraintestinal manifestations (EIM) of IBD such as arthralgia/arthritis, ankylosing spondylitis, pyoderma gangraenosum, erythema nodosum and uveitis. Pain is also an important manifestation of inflammation. Inflammatory cytokines and mediators sensitize primary afferent neurons. However, inflammation does not fully explain pain in many IBD patients: about 20% of patients in clinical and endoscopic remission continue experiencing pain.
The patients of the Swiss IBD Cohort Study (SIBDCS) (n=2152) received a questionnaire regarding pain localization, impact of pain on daily life, how the surrounding responds to the patients' pain and how activities of daily life are influenced. Furthermore the questionnaire investigated the use of pain medication. Additionally, using prospectively collected data from the Swiss IBD cohort study, we compared the disease characteristics of the participating patients with the data of the questionnaire.
Among a total of 1258 completed questionnaires (response rate 58.5%) the vast majority of patients reported having experienced pain during the course of the disease. Only 11.2% of the patients reported no pain. With regard to chronicity we found pain to be a longstanding problem with 17.8% of patients reporting pain since 2-5 years prior to the current assessment and even more than a third of patients (37.4%) reporting pain since more than 5 years. Almost one in six patients (14%) reported to experience pain every day. Pain medication could not sufficiently ameliorate pain.
Pain is an important factor of disease presentation of IBD. It is present in many more patients than generally assumed. Moreover, pain is a longstanding problem for the majority of the patients affected. Thus, an increased awareness is mandatory address this frequent complication in the course of IBD.