Patients in remission from inflammatory bowel diseases may complain of pain. They would represent between 23.5% and 33.6% of patients, a non-negligible proportion for specialists.
- According to a British meta-analysis, between 23.5 and 33.6% of patients in remission from inflammatory bowel disease suffer.
- This figure fluctuates depending on how remission of the disease is established.
- The researchers advocate a “psychological well-being” approach to help them.
The disease regresses but yet the pain remains. This is what at least one in 5 people in remission from inflammatory bowel disease say, according to a meta-analysis conducted by gastroenterologist researchers at the University of Leeds (UK). published this 1er October in The Lancet magazine. They conclude that “IPatients with inflammatory bowel disease (IBD) often report symptoms consistent with irritable bowel syndrome (IBS), which could have an effect on psychological health.” They believe that previous studies on this subject were not exhaustive enough.
To better measure this phenomenon, the researchers looked at all the studies published on three medical bibliographic databases between 1er January 2012 and May 11, 2020. There, they pre-selected prospective or cross-sectional case-control studies reporting the prevalence of symptoms meeting diagnostic criteria for IBS in adults with IBD in remission. Next, they retained research on an unselected adult population (more than 90% of participants aged 16 or older) with histologically or radiologically confirmed IBD and involving at least 50 participants. There, they categorized the various definitions of “remission” and leveled their statistical calculations on measures of inflammatory bowel disease as well as irritable bowel syndrome. To this is added theassociation between reporting IBS-like symptoms, as well as estimation of psychological comorbidity using the weighted mean difference or standard mean difference, in anxiety and depression scores between those reporting IBS-like symptoms SCI and those other patients.
Results
Thus this selection and calculation work resulted in 3,370 studies identified and 27 eligible, including 18 newly identified. This meta-analysis is therefore unprecedented compared to previous studies on the subject. Thus, according to British researchers, among 3,169 patients with IBD in remission, 32.5% reported suffering from IBS-like symptoms. This rate decreases and reaches 23.5% if remission is observed by endoscopic evaluation, or 25.8% by histological evaluation. However, the finding of remission via a validated clinical disease activity index brings the number of patients suffering to 33.6% and mainly concerns Crohn’s patients (36.6%) rather than those with ulcerative colitis (28 .7%).
These results are consistent with the anxiety and depression scores of people who claim to be suffering compared to other patients in remission who are not suffering. Thus according to the definition of remission, people complaining of pain oscillating between 23.5% and 33.6%, or between 1/5 and 1/3. “Addressing psychological well-being could improve outcomes in this specific group of patients,” recommend the researchers. Remission means that the disease is regressing and not that it has disappeared, unfortunately for these patients.
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