Age-Related Decrease in Abdominal Pain and Associated Structural- and Functional Mechanisms: An Exploratory Study in Healthy Individuals and Irritable Bowel Syndrome Patients

Beckers, Abraham B.; Wilms, Ellen; Mujagic, Zlatan; Kajtár, Béla; Csekő, Kata; Weerts, Zsa Zsa R M; Vork, Lisa; Troost, Freddy J.; Kruimel, Joanna W.; Conchillo, José M.; Helyes, Zsuzsanna; Masclee, Ad; Keszthelyi, Dániel; Jonkers, Daisy

doi:10.3389/fphar.2021.806002

Cited by 16 publications

(17 citation statements)

References 30 publications

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“…Similarly, a 2012 meta‐analysis of 14 studies demonstrated that IBS was more prevalent in those under 50 years of age, compared to those over 50 50 . Our results extend upon these findings, demonstrating that not only may FGID prevalence be greater in younger adult age groups, but FGID overlap is also more prevalent perhaps partly due to greater visceral hypersensitivity in younger patients 51,52 …”

Section: Discussionsupporting

confidence: 79%

“…50 Our results extend upon these findings, demonstrating that not only may FGID prevalence be greater in younger adult age groups, but FGID overlap is also more prevalent perhaps partly due to greater visceral hypersensitivity in younger patients. 51,52 Increasing FGID overlap was strongly associated with worse quality of life in our study, in both the overall constipation analysis and FDD sub-analysis. Reductions in quality of life were particularly strong in domains that assessed the impact of poor health on exercise capacity, employment, activities of daily living, social interactions, and community involvement, 33 which are important factors for future health and independence.…”

Section: Discussionsupporting

confidence: 50%

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Experiencing multiple concurrent functional gastrointestinal disorders is associated with greater symptom severity and worse quality of life in chronic constipation and defecation disorders

Kaplan

Mazor

Prott

et al. 2022

Neurogastroenterology Motil

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Background Recent community‐based studies have demonstrated that experiencing multiple concurrent functional gastrointestinal disorders (FGIDs) is associated with increased somatization, worse quality of life (QoL), and greater health care utilization. However, the presence of multiple overlapping FGIDs is unstudied specifically in chronic constipation and functional defecation disorders (FDD). We investigated the prevalence and impact of additional nonconstipation FGIDs on constipation severity, anorectal physiology, anxiety and depression, and QoL, in patients with chronic constipation and FDD. Methods One‐hundred and forty‐six consecutive patients with functional constipation or irritable bowel syndrome (IBS‐C/IBS‐M) presenting to a tertiary referral Neurogastroenterology Clinic were studied. In addition, 90/146 (62%) qualified for FDD due to abnormal defecatory physiology. Patients underwent comprehensive baseline assessment comprising anorectal physiology, Bristol Stool Chart, Rome questionnaire, Knowles‐Eccersley‐Scott‐Symptom (KESS) constipation score, Hospital Anxiety, and Depression Scale, and modified 36‐Item Short Form Health Survey (SF‐36) for QoL. Additional FGIDs were diagnosed using Rome III criteria. Key Results Additional nonconstipation FGIDs occurred in 85% of patients, with a mean of 2.1 (SD 1.6) additional FGIDs. Patients with four or more additional FGIDs experienced greater constipation severity compared to those with no additional FGIDs (p = 0.004). Comorbid FGIDs were associated with worse SF‐36 scores for physical functioning (p < 0.001), role‐physical (p = 0.005), bodily pain (p < 0.001), vitality (p = 0.008), social functioning (p = 0.004), and mental health index (p = 0.031). Conclusions and Inferences Functional gastrointestinal disorders comorbidity is highly prevalent in chronic constipation and defecatory disorders, and this is associated with greater symptom severity and worse QoL. Multimodal treatments targeting comorbid FGIDs may lead to superior outcomes.

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Section: Discussionsupporting

confidence: 79%

Section: Discussionsupporting

confidence: 50%

Experiencing multiple concurrent functional gastrointestinal disorders is associated with greater symptom severity and worse quality of life in chronic constipation and defecation disorders

Kaplan

Mazor

Prott

et al. 2022

Neurogastroenterology Motil

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“…Previous data found that the prevalence of FGIDs decreased with age in Internet survey countries 3 (which may be related to age‐related decrease in abdominal pain perceptions 10 ). We observed increased prevalence of prescription pain medication usage with age.…”

Section: Discussionmentioning

confidence: 94%

Global patterns of prescription pain medication usage in disorders of gut–brain interactions

Luo

Camey

Bangdiwala

et al. 2022

Neurogastroenterology Motil

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Background Forty percent of individuals globally meet Rome IV criteria for a disorder of gut–brain interaction (DGBI). The global burden of pain across these disorders has not been characterized. Methods Our study included 54,127 respondents from the 26 Internet survey countries. Prescription pain medication usage was selected as the proxy for pain. The associations between prescription pain medications and the environmental, sociodemographic, psychosocial, and DGBI diagnosis variables were investigated using the multivariate generalized robust Poisson regression model. Key Results Respondents with DGBI used prescription pain medications at higher rates than those without a DGBI diagnosis with pooled prevalence rate of 14.8% (95% confidence interval [CI], 14.4–15.3%), varying by country from 6.8% to 25.7%. The pooled prevalence ratio of prescription pain medication usage in respondents with and without DGBI was 2.2 (95% CI: 2.1–2.4). Factors associated with higher prevalence of pain medication usage among respondents with a DGBI diagnosis included living in a small community, increased anxiety, depression or somatization, increased stress concern or embarrassment about bowel functioning and having more than one anatomic DGBI diagnosis. Conclusion 14.8% of patients globally with at least one diagnosis of DGBI were on prescription pain medications with wide geographic variation, about twice as many as their counterparts without a diagnosis of DGBI. Environmental, sociodemographic, and individual factors may influence clinicians to consider personalized, multimodal approaches to address pain in patients with DGBI.

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“…Research on disease activity patterns for IBD is scarce, but suggests a more intermittent or even chronic inflammation pattern in newly diagnosed CD patients 31 . In IBS, it has previously been shown that abdominal pain may attenuate over time in patients who get older or have a longer duration of symptoms 32 . Acceptance of diagnosis or symptoms over the years may play a role in the perception of pain.…”

Section: Discussionmentioning

confidence: 99%

Abdominal pain in patients with inflammatory bowel disease in remission: A prospective study on contributing factors

Janssen,

Rezazadeh Ardabili,

Romberg‐Camps

et al. 2023

Aliment Pharmacol Ther

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SummaryBackgroundAbdominal pain is highly prevalent in patients with inflammatory bowel disease (IBD) in remission, but the aetiology is incompletely understood.AimTo investigate the association of clinical, lifestyle and psychosocial factors with abdominal pain in patients with IBD in remission.MethodsWe performed a prospective multicentre study enrolling consecutive patients with IBD. Data were collected between 1 January 2020 and 1 July 2021, using myIBDcoach, an established remote monitoring platform for IBD. Chronic abdominal pain in IBD in remission (IBDremissionPain+) was defined as abdominal pain score ≥3 (0–10 NRS) on ≥1/3 of all assessments, combined with faecal calprotectin <150 μg/g in 90 days around periodic assessments. Disease activity, lifestyle and psychosocial factors were assessed every 1–3 months during 18 months. Using linear mixed models, the association of these factors with abdominal pain over time was analysed.ResultsWe included 559 patients, of whom 429 (76.7%) remained in biochemical remission. Of these, 198 (46.2%) fulfilled the criteria for chronic abdominal pain. IBDremissionPain+ patients were characterised by female sex, younger age, higher BMI, and shorter disease duration. They reported more often or higher levels of stress, fatigue, depressive and anxiety symptoms, and life events (all p < 0.001). In the multivariable analysis, sex, disease entity, fatigue, depressive symptoms and life events were associated with abdominal pain over time (all p < 0.05).ConclusionIn this cohort of patients with IBD in remission, abdominal pain was common and associated with psychosocial factors. A more holistic treatment approach for patients with IBD suffering from abdominal pain may improve quality of care and subjective wellbeing.

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Age-Related Decrease in Abdominal Pain and Associated Structural- and Functional Mechanisms: An Exploratory Study in Healthy Individuals and Irritable Bowel Syndrome Patients

Cited by 16 publications

References 30 publications

Experiencing multiple concurrent functional gastrointestinal disorders is associated with greater symptom severity and worse quality of life in chronic constipation and defecation disorders

Experiencing multiple concurrent functional gastrointestinal disorders is associated with greater symptom severity and worse quality of life in chronic constipation and defecation disorders

Global patterns of prescription pain medication usage in disorders of gut–brain interactions

Abdominal pain in patients with inflammatory bowel disease in remission: A prospective study on contributing factors

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