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IBS-like Symptoms in Patients with Ulcerative Colitis in Deep Remission Are Associated with Increased Levels of Serum Cytokines and Poor Psychological Well-being

Artikel i vetenskaplig tidskrift
Författare Börje Jonefjäll
Lena Öhman
Magnus Simrén
Hans Strid
Publicerad i Inflammatory Bowel Diseases
Volym 22
Nummer/häfte 11
Sidor 2630-2640
ISSN 1078-0998
Publiceringsår 2016
Publicerad vid Institutionen för biomedicin, avdelningen för mikrobiologi och immunologi
Institutionen för medicin, avdelningen för invärtesmedicin och klinisk nutrition
Sidor 2630-2640
Språk en
Ämnesord ulcerative colitis: general clinical, irritable bowel syndrome in IBD, inflammation in IBD, psychosocial aspects of IBD, inflammatory-bowel-disease, quality-of-life, gastrointestinal symptoms, fecal calprotectin, clinical remission, celiac-disease, health, impact, scale, questionnaire, Gastroenterology & Hepatology, hroeder kw, 1987, new england journal of medicine, v317, p1625
Ämneskategorier Klinisk medicin

Sammanfattning

Background:Gastrointestinal symptoms (GI) compatible with irritable bowel syndrome (IBS) are common in patients with ulcerative colitis (UC) in remission. The causes of these symptoms remain to be clarified. Our aim was to investigate prevalence and factors associated with IBS-like symptoms in patients with UC in deep remission.Methods:We included 298 patients with UC and used Mayo score, sigmoidoscopy, and fecal calprotectin to define deep remission versus active disease. Presence of IBS-like symptoms according to the Rome III criteria, severity of GI, extraintestinal and psychological symptoms, stress levels, and quality of life were measured with validated questionnaires. Serum cytokines and high-sensitive C-reactive peptide were determined.Results:The criteria for deep remission was fulfilled by 132 patients (44%) and 24 of these fulfilled the Rome III criteria for IBS (18%). Patients with UC in deep remission with IBS-like symptoms had comparable levels of GI symptoms, non-GI somatic symptoms, and quality of life as patients with active UC. The patients with UC in deep remission with IBS-like symptoms had similar levels of fecal calprotectin as patients in deep remission without IBS-like symptoms (18 versus 31 g/g, P = 0.11), but higher levels of serum cytokines (interleukin [IL]-1, IL-6, IL-13, IL-10 and IL-8, P < 0.05) and higher levels of anxiety (P < 0.001), depression (P = 0.02) and perceived stress (P = 0.03).Conclusions:IBS-like symptoms in patients with UC in deep remission are common, but not as prevalent as previously reported. Poor psychological well-being and increased serum cytokine levels, but not colonic low-grade inflammation, were associated with IBS-like symptoms.

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