Irritable Bowel-like Symptoms in Ulcerative Colitis are as Common in Patients in Deep Remission as in Inflammation: Results From a Population-based Study [the IBSEN Study]

J Crohns Colitis. 2018 Mar 28;12(4):389-393. doi: 10.1093/ecco-jcc/jjx152.

Abstract

Background and aims: An increased prevalence of irritable bowel syndrome [IBS]-like symptoms has been reported in patients with ulcerative colitis [UC]. Whether ongoing inflammation increases the prevalence of such symptoms is unknown. The aims of this study were to determine the prevalence of IBS-like symptoms in a population-based cohort of UC patients 20 years after diagnosis, and to assess the possible association between such symptoms and ongoing inflammation.

Methods: Patients diagnosed with UC between 1990 and 1994, in a geographically well-defined area, were included in a prospective follow-up study, and IBS symptoms according to Rome III criteria were recorded 20 years after diagnosis. The patients underwent colonoscopy with biopsies and/or the level of faecal calprotectin was analysed.

Results: A total of 260 patients answered the Rome III questionnaire. The overall prevalence of IBS-like symptoms was 27%. In patients who had no signs of inflammation in colonic biopsies [n = 96] [deep remission], the prevalence was 29%. No difference in prevalence of IBS-like symptoms was found between patients with ongoing inflammation and patients in deep remission.

Conclusions: IBS-like symptoms in UC patients are frequent after 20 years of disease. Deep remission did not change the frequency of IBS-like symptoms.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Biopsy
  • Colitis, Ulcerative / complications
  • Colitis, Ulcerative / pathology*
  • Colon / pathology
  • Colonoscopy
  • Feces / chemistry
  • Female
  • Follow-Up Studies
  • Humans
  • Inflammation / complications
  • Inflammation / pathology*
  • Irritable Bowel Syndrome / epidemiology*
  • Irritable Bowel Syndrome / etiology
  • Leukocyte L1 Antigen Complex / analysis
  • Male
  • Middle Aged
  • Prevalence
  • Prospective Studies
  • Severity of Illness Index
  • Surveys and Questionnaires
  • Symptom Assessment

Substances

  • Leukocyte L1 Antigen Complex