Introduction Pain is a commonly experienced and burdensome symptom in patients with Inflammatory Bowel Disease (IBD). A substantial number of patients continue to experience pain while the disease is in remission. Research exploring factors in IBD-pain is sparse. This study aimed to explore sociodemographic, clinical and psychosocial factors associated with pain frequency in patients with IBD.
Method Patients recruited from outpatient IBD services completed the United Kingdom Inflammatory Bowel Disease Questionnaire (UK IBDQ) and a number of sociodemographic, clinical and psychosocial measures. In the secondary analysis of these data, item 13 from the UK IBDQ measuring pain frequency, “On how many days over the last two weeks have you felt pain in your abdomen?”, was utilised as the primary outcome. Sociodemographic, disease-related and laboratory data were retrieved from patients’ hospital electronic medical records. Patients completed a number of self-report measures including: IBD-Fatigue Scale (IBD-F) and Multidimensional Fatigue Inventory (MFI), Hospital Anxiety and Depression Scale (HADS), IBD-Distress Scale (IBD-DS), Cohen Perceived Stress Scale (PSS), Brief Illness Perceptions Questionnaire (BIPQ) and Cognitive and Behavioural Responses to Symptoms Questionnaire (CBSQ). Univariate and multivariate analyses were conducted to test the relationship between pain frequency and sociodemographic, clinical and psychosocial variables.
Results 182 patients with IBD took part in the study (57% female, 64% Crohn’s Disease, mean age 37.0 years). In univariate analyses, greater pain frequency was significantly associated with disease activity and fatigue. Female patients, those with active disease and taking steroids reported significantly more pain frequency. All emotional, cognitive and behavioural factors in psychosocial measures had significant positive correlations with pain frequency. In multivariate analyses, disease activity (p=0.01) and fatigue measured by the MFI (p=0.04), were significant predictors of pain frequency and explained 26% of the variance. Emotional, cognitive and behavioural factors were not found to predict pain frequency.
Conclusion Fatigue and disease activity were independent predictors of pain frequency in patients with IBD. Utilising a single pain item from the IBDQ, none of the psychosocial factors were found to predict pain frequency. Further research, using more comprehensive pain measures, capturing pain severity and frequency is required to explore the relationship between pain and psychosocial factors in IBD. This knowledge may help in the development of pain management interventions.
Disclosure of Interest None Declared
- Abdominal pain
- Inflammatory Bowel Disease
- Psychosocial factors
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