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

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  • Additional Information
    • Source:
      Publisher: Oxford University Press Country of Publication: England NLM ID: 9508162 Publication Model: Print Cited Medium: Internet ISSN: 1536-4844 (Electronic) Linking ISSN: 10780998 NLM ISO Abbreviation: Inflamm Bowel Dis Subsets: MEDLINE
    • Publication Information:
      Publication: 2018- : [Oxford] : Oxford University Press
      Original Publication: New York, NY : Raven Press, c1995-
    • Subject Terms:
      Severity of Illness Index* ; Symptom Flare Up*; Colitis, Ulcerative/*blood ; Colitis, Ulcerative/*psychology ; Cytokines/*blood; Adolescent ; Adult ; Aged ; Anxiety/epidemiology ; Anxiety/etiology ; Colitis, Ulcerative/drug therapy ; Depression/epidemiology ; Depression/etiology ; Female ; Humans ; Male ; Middle Aged ; Remission Induction ; Stress, Psychological/epidemiology ; Stress, Psychological/etiology ; Young Adult
    • Abstract:
      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 μg/g, P = 0.11), but higher levels of serum cytokines (interleukin [IL]-1β, 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.
    • Comments:
      Comment in: Inflamm Bowel Dis. 2017 Jan;23 (1):E4-E5. (PMID: 27930410)
      Comment in: Inflamm Bowel Dis. 2017 Feb;23 (2):E11-E12. (PMID: 28079624)
    • Accession Number:
      0 (Cytokines)
    • Publication Date:
      Date Created: 20160917 Date Completed: 20180123 Latest Revision: 20220408
    • Publication Date:
      20221213
    • Accession Number:
      10.1097/MIB.0000000000000921
    • Accession Number:
      27636379