Chronic Abdominal Pain in Patients with Inflammatory Bowel Disease in Remission: A Continuing Challenge for Clinicians

Dig Dis Sci. 2024 Dec;69(12):4336-4346. doi: 10.1007/s10620-024-08716-y. Epub 2024 Nov 13.

Abstract

Inflammatory bowel disease (IBD) is a chronic condition that includes ulcerative colitis and Crohn's disease. It is characterized by a relapsing and remitting pattern that negatively impacts quality of life (QoL). Current goals of treatment involve symptomatic, biochemical, and endoscopic remission in a treat-to-target approach. Despite effective treatment and remission of IBD, many patients report frequent and isolated abdominal pain. A wide range of etiologies exist, including surgery-related, infections, pelvic conditions, immune-related, and systemic illnesses. Disorders of the gut-brain interaction (DGBI), frequently characterized by abdominal pain, are increasingly recognized in IBD patients, including those with quiescent disease. Various mechanisms are involved and numerous non-pharmacologic and pharmacologic therapies have been proposed. Hereby, we outline the pertinent findings of the literature on management of chronic abdominal pain, focusing on quiescent IBD.

Keywords: Abdominal pain; Crohn’s disease; IBD; IBS; Quiescent IBD; Ulcerative colitis.

Publication types

  • Review

MeSH terms

  • Abdominal Pain* / etiology
  • Abdominal Pain* / therapy
  • Brain-Gut Axis
  • Chronic Pain / diagnosis
  • Chronic Pain / etiology
  • Chronic Pain / therapy
  • Humans
  • Inflammatory Bowel Diseases* / complications
  • Inflammatory Bowel Diseases* / therapy
  • Quality of Life
  • Remission Induction