Pain Clinical Trial
Official title:
Epidemiology and Characterization of Pain in Patients With Crohn Disease
Abdominal pain is a common symptom in patients with Crohn disease (CD). Pain is
multifactorial, may result from inflammation but persists in many patients during remission.
The aim of our study is to determine the epidemiology of pain in CD patients and define the
characteristics of pain : localisation, temporal and sensorial characteristics, neuropathic
component, impact on quality of life and mood.
Abdominal pain is a common symptom in patients with inflammatory bowel disease (IBD) that
alters quality of life and can lead to increased healthcare utilization. In addition to
abdominal pain, pain can result from extra-intestinal manifestation of IBD. 40% of IBD
patients suffer from extra-intestinal manifestations. Although abdominal pain has been
traditionally attributed to inflammation, functional abdominal pain exists in patients with
IBD, associated with a variety of potential causes. About 20-40% of patients in complete
clinical and endoscopic remission continue to experience chronic pain. Thus, when examining
an IBD patient with abdominal pain, in addition to IBD-related complications (e.g.,
inflammation, stricture), it is important to screen for other contributors, including
peripheral factors (visceral hypersensitivity, bacterial overgrowth, and bowel dysmotility)
and centrally mediated neurobiological and psychosocial underpinnings. These central factors
include psychological symptoms, sleep disturbance, and stress. Opioid-induced hyperalgesia
(e.g., narcotic bowel syndrome) is also growing in recognition as a potential central source
of abdominal pain.
Pronounced severe pain impacts health related quality of life (QoL). Longstanding pain leads
to decreased QoL, increase in pain medication intake, and co-morbidities including
depression, anxiety and even addiction. Furthermore, pain attacks severely interfere with
social and professional life.
Knowledge of these potential aetiologies should be used to individualize treatment of
abdominal pain in patients with IBD. Accurate assessment of the source of pain can help guide
appropriate diagnosis workup and use of modifying therapy.
The aim of the study is to determine the epidemiology of pain in patients with Crohn disease
(CD) and to characterize their pain (localisation, temporal characteristics, acute vs.
chronic, sensorial characteristics, existence of neuropathic component, existence of
hyperalgesia), and their impact of QoL, depression and anxiety
;
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