Chronic Abdominal Pain in IBD Research Initiative: Unraveling Biological Mechanisms and Patient Heterogeneity to Personalize Treatment and Improve Clinical Outcomes

Research-Based Product Innovation to Address Critical Unmet Needs of Patients with Inflammatory Bowel Diseases

“… 46 , 50 Potential for the treatment of chronic abdominal pain has also been proposed. 51 However, despite intense interest in this field, relatively few microbiome-based interventions other than antibiotics have progressed to the clinic to date ( Fig. 3 ; Supplementary Table 1 ).…”

“…Modalities such as cognitive behavioral therapy (CBT) also have significant potential to empower patients to control pathological brain processes, such as central sensitization, that increase risks of chronic pain and other negative outcomes in IBD. 51 Digital therapeutics integrated with telemedicine approaches have the potential to broaden patient access to behavioral therapy.…”

Purinergic Pathways in the Spinal Microglia as a Putative Target for Treatment of Chronic Abdominal Pain

“…Their findings had also important clinical implications by increasing the understanding of the mechanisms underlying mechanical, neuropathic, and inflammatory pain. 2 Although knowledge in this area has grown dramatically in the last 2 decades, pain management remains a major clinical challenge, 3 in part because of persistent knowledge gaps in genesis of chronic pain.…”

“…Although in many patients with IBD, pain is triggered by active inflammation, in others, pain can persist despite histologic and inflammatory biomarker normalization. 3 A British survey reported that up to 50% of patients with Crohn's disease and 37% of patients with ulcerative colitis suffered from abdominal pain, regardless of whether the disease was in relapse or remission. 4 A large European study of almost 5000 patients with IBD found that 62% of them reported pain during colitis remission, 5 suggesting that mechanisms underlying chronic pain are independent of active inflammation.…”

“…Pain management in IBD is challenging because available therapies, such as nonsteroidal anti-inflammatory drugs, antispasmodics, or opiates, often provide inadequate relief, may contribute to morbidity, and pose risk of addiction. 3 Indeed, opiate usage among patients with IBD is common, with a recent study reporting opioid prescription in more than a third of patients when being discharged from the emergency department. 6 Thus, there is an urgent need to develop safer and novel treatment modalities to effectively manage chronic abdominal pain, which requires better understanding of its pathophysiology.…”