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Review
. 2022 Jul 22;11(15):4269.
doi: 10.3390/jcm11154269.

Abdominal Pain in Inflammatory Bowel Diseases: A Clinical Challenge

Pauline Wils  1 , Bénédicte Caron  2   3 , Ferdinando D'Amico  4   5 , Silvio Danese  4 , Laurent Peyrin-Biroulet  2   3
Affiliations
Review

Abdominal Pain in Inflammatory Bowel Diseases: A Clinical Challenge

Pauline Wils et al. J Clin Med. .

Abstract

Up to 60% of inflammatory bowel disease (IBD) patients experience abdominal pain in their lifetime regardless of disease activity. Pain negatively affects different areas of daily life and particularly impacts the quality of life of IBD patients. This review provides a comprehensive overview of the multifactorial etiology implicated in the chronic abdominal pain of IBD patients including peripheral sensitization by inflammation, coexistent irritable bowel syndrome, visceral hypersensitivity, alteration of the brain-gut axis, and the multiple factors contributing to pain persistence. Despite the optimal management of intestinal inflammation, chronic abdominal pain can persist, and pharmacological and non-pharmacological approaches are necessary. Integrating psychological support in care models in IBD could decrease disease burden and health care costs. Consequently, a multidisciplinary approach similar to that used for other chronic pain conditions should be recommended.

Keywords: abdominal pain; inflammatory bowel disease; quality of life.

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Conflict of interest statement

P.W. declares no conflict of interest. B.C. declares no conflict of interest. F.D. declares no conflict of interest. S.D. has served as a speaker, consultant, and advisory board member for Schering-Plough, AbbVie, Actelion, Alphawasserman, AstraZeneca, Cellerix, Cosmo Pharmaceuticals, Ferring, Genentech, Grunenthal, Johnson and Johnson, Millenium Takeda, MSD, Nikkiso Europe GmbH, Novo Nordisk, Nycomed, Pfizer, Pharmacosmos, UCB Pharma, and Vifor. L.P.-B. declares personal fees from Galapagos, AbbVie, Janssen, Genentech, Ferring, Tillots, Celltrion, Takeda, Pfizer, Index Pharmaceuticals, Sandoz, Celgene, Biogen, Samsung Bioepis, Inotrem, Allergan, MSD, Roche, Arena, Gilead, Amgen, BMS, Vifor, Norgine, Mylan, Lilly, Fresenius Kabi, OSE Immunotherapeutics, Enthera, Theravance, Pandion Therapeutics, Gossamer Bio, Viatris, Thermo Fisher; grants from Abbvie, MSD, Takeda, and Fresenius Kabi; stock options: CTMA.

Figures

Figure 1
Figure 1
Proposed representation of mechanisms and multiple contributing factors implicated in abdominal pain in IBD: psychological and social factors, genetic factors, direct effect of inflammation, visceral hypersensitivity, co-existent IBS or central pain dysregulation. Abbreviations: IBS: irritable bowel syndrome; SIBO: Small intestinal bacterial overgrowth.
Figure 2
Figure 2
Proposed algorithm for pain management with pharmacological agents and non-pharmacological interventions available for improve chronic abdominal pain.
See this image and copyright information in PMC

References

    1. Khanna R., Zou G., D’Haens G., Feagan B.G., Sandborn W.J., Vandervoort M.K., Rolleri R.L., Bortey E., Paterson C., Forbes W.P., et al. A Retrospective Analysis: The Development of Patient Reported Outcome Measures for the Assessment of Crohn’s Disease Activity. Aliment. Pharmacol. Ther. 2015;41:77–86. doi: 10.1111/apt.13001. - DOI - PubMed
    1. Turner D., Ricciuto A., Lewis A., D’Amico F., Dhaliwal J., Griffiths A.M., Bettenworth D., Sandborn W.J., Sands B.E., Reinisch W., et al. STRIDE-II: An Update on the Selecting Therapeutic Targets in Inflammatory Bowel Disease (STRIDE) Initiative of the International Organization for the Study of IBD (IOIBD): Determining Therapeutic Goals for Treat-to-Target Strategies in IBD. Gastroenterology. 2021;160:1570–1583. doi: 10.1053/j.gastro.2020.12.031. - DOI - PubMed
    1. Zeitz J., Ak M., Müller-Mottet S., Scharl S., Biedermann L., Fournier N., Frei P., Pittet V., Scharl M., Fried M., et al. Pain in IBD Patients: Very Frequent and Frequently Insufficiently Taken into Account. PLoS ONE. 2016;11:e0156666. doi: 10.1371/journal.pone.0156666. - DOI - PMC - PubMed
    1. Coates M.D., Johri A., Gorrepati V.S., Maheshwari P., Dalessio S., Walter V., Stuart A., Koltun W., Bernasko N., Tinsley A., et al. Abdominal Pain in Quiescent Inflammatory Bowel Disease. Int. J. Colorectal Dis. 2021;36:93–102. doi: 10.1007/s00384-020-03727-3. - DOI - PMC - PubMed
    1. Colombel J.-F., Shin A., Gibson P.R. AGA Clinical Practice Update on Functional Gastrointestinal Symptoms in Patients with Inflammatory Bowel Disease: Expert Review. Clin. Gastroenterol. Hepatol. 2019;17:380–390.e1. doi: 10.1016/j.cgh.2018.08.001. - DOI - PMC - PubMed

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