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Characterization of IBS-like symptoms in patients with ulcerative colitis in clinical remission

Artikel i vetenskaplig tidskrift
Författare Börje Jonefjäll
Hans Strid
Lena Öhman
Jan Svedlund
A Bergstedt
Magnus Simrén
Publicerad i Neurogastroenterology and Motility
Volym 25
Nummer/häfte 9
Sidor 756-E578
ISSN 1350-1925
Publiceringsår 2013
Publicerad vid Centrum för personcentrerad vård vid Göteborgs universitet (GPCC)
Institutionen för neurovetenskap och fysiologi, sektionen för psykiatri och neurokemi
Institutionen för biomedicin, avdelningen för mikrobiologi och immunologi
Institutionen för medicin, avdelningen för invärtesmedicin och klinisk nutrition
Sidor 756-E578
Språk en
Länkar dx.doi.org/10.1111/nmo.12163
Ämnesord Fecal Calprotectin, Functional GI symptoms, IBD, IBS, Ulcerative Colitis, inflammatory-bowel-disease, quality-of-life, fecal calprotectin, gastrointestinal symptoms, therapy, pathogenesis, prevalence, protein, health, impact
Ämneskategorier Klinisk medicin

Sammanfattning

Background Gastrointestinal symptoms compatible with Irritable Bowel Syndrome (IBS) are common in patients with inflammatory bowel disease. It has been suggested that these symptoms are a reflection of occult inflammation rather than coexisting IBS. The aim of this study was to characterize IBS-like symptoms in patients with Ulcerative Colitis (UC) in clinical remission by assessing inflammatory markers, psychological symptoms, and quality of life. Methods Ninety-four patients with new onset of UC were followed prospectively during 3 years with yearly follow-up visits. The patients completed self-administrated questionnaires. Fecal calprotectin was used as an inflammatory biomarker. Remission was defined as a total Mayo-score <= 2 and an endoscopic subscore <= 1, with no relapse during the 3-month period prior to visit. Key Results The prevalence of patients that fulfilled Rome II criteria for IBS among UC patients in remission was 11% at visit 1, 23% at visit 2, and 17% at visit 3. When comparing UC patients in remission with and without IBS-like symptom, patients with IBS-like symptoms had more severe gastrointestinal symptoms, tendencies toward more severe psychological symptoms and reduced levels of quality of life, but the calprotectin levels did not differ between the two groups. Conclusions & Inferences IBS-like symptoms are common in patients with UC in clinical remission and these fluctuate over time. The symptoms are associated with poor psychological wellbeing and reduced quality of life, and do not seem to be a reflection of low-grade inflammatory activity.

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