SAN DIEGO — IBS-like symptoms in patients with ulcerative colitis in remission may be related to poor psychological well-being instead of physical issues such as inflammation, according to data presented at the 2012 Digestive Disease Week Annual Meeting.
Researchers followed 95 patients with recent-onset ulcerative colitis for three years with annual follow-up visits. At each visit, participants completed questionnaires assessing whether they fulfilled the Rome II criteria for IBS, as well as the severity of their GI symptoms, their quality of life and indications of psychological symptoms such as anxiety or depression. Patients experiencing remission of their ulcerative colitis who experienced IBS-like symptoms were compared with patients in remission without IBS symptoms at each visit.
Patients in remission fulfilled the IBS criteria in seven cases during the first visit (12% of patients in remission), 15 cases at the second visit (23%) and 11 cases during the third visit (17%). These patients reported more severe GI symptoms than patients who did not fulfill IBS criteria (P<.01 at each visit). The IBS group also tended more toward psychological symptoms and lower quality of life, reporting more depression and anxiety at all three visits than patients without IBS symptoms. Investigators observed that the levels of inflammatory marker calprotectin did not significantly differ between patients with and without IBS symptoms (P=.54 at the first visit, P=.72 at second visit and P=.79 at third visit).
“In patients with ulcerative colitis in clinical remission that have IBS-like symptoms, we have found no signs of inflammation, low-grade disease activity, and the levels of calprotectin were not elevated,” researcher Börje Jonefjäll, MD, told Healio.com. “It’s important to not think that these IBS-like symptoms are disease activity so you don’t overtreat these patients. We found signs that [patients] had higher degrees of depression, anxiety and a lower quality of life, not higher levels of inflammatory markers, and we should treat these symptoms for what they are.”
For more information:
Jonefjäll B. #Mo1664: Characterization of IBS-Like Symptoms in Patients With Ulcerative Colitis in Clinical Remission. Presented at: the 2012 Digestive Disease Week Annual Meeting; May 19-22,San Diego.