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Lifestyle Factors Associated with Abdominal Pain in Quiescent Inflammatory Bowel Disease

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Abstract

Background

Lifestyle factors, including diet, exercise, substance use, and sexual activity, have been shown to influence risk of inflammation and complications in inflammatory bowel disease (IBD), including Crohn’s disease (CD) and ulcerative colitis (UC). Little is known about their potential role in abdominal pain generation in IBD.

Aims

We performed this study to evaluate for relationships between lifestyle factors and abdominal pain in quiescent IBD (QP-IBD).

Methods

We performed a retrospective analysis utilizing data from our institution’s IBD Natural History Registry (January 1, 2017–December 31, 2022). Endoscopic evaluation, concurrent laboratory studies and surveys were completed by participants. Demographic and clinical data were also abstracted.

Results

We identified 177 consecutive patients with quiescent disease (105 females:72 males; 121 with CD:56 with UC) for participation in this study, 93 (52.5%) had QP-IBD. Compared to patients with quiescent IBD without pain (QNP-IBD, patients with QP-IBD exhibited no significant differences in IBD type, location, severity or complication rate. Patients with QP-IBD were more likely to have anxiety/depression (55.9% vs. 32.1%, p = 0.002) and to use antidepressants/anxiolytics (49.5% vs. 21.4%, p < 0.001). They were also less likely to engage in exercise at least three times per week (39.8% vs. 54.8%, p = 0.05) or participate in sexual activity at least monthly (53.8% vs. 69.1%, p = 0.04). On logistic regression analysis, antidepressant and/or anxiolytic use was independently associated with QP-IBD [2.72(1.32–5.62)], while monthly sexual activity was inversely associated [0.48(0.24–0.96)].

Conclusion

Lifestyle factors, including the lack of sexual activity and exercise, are significantly associated with QP-IBD. Further study is warranted to clarify the relationships between these factors and the development of abdominal pain in quiescent IBD.

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Funding

This research was supported by the Peter and Marsha Carlino Early Career Professorship in Inflammatory Bowel Disease, the Margot E. Walrath Career Development Professorship in Gastroenterology and the National Institutes of Health (National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) R01DK122364).

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Authors and Affiliations

  1. Division of Gastroenterology and Hepatology, Department of Medicine, Pennsylvania State University College of Medicine, Hershey, PA, USA

    Matthew D. Coates, Shannon Dalessio, August Stuart, Andrew Tinsley, Emmanuelle D. Williams & Kofi Clarke

  2. Department of Public Health Sciences and Department of Biochemistry, Pennsylvania State University College of Medicine, Hershey, PA, USA

    Vonn Walter

  3. Division of Gastroenterology and Hepatology, Penn State University Hershey Medical Center, 500 University Drive, M.C. HU33, Hershey, PA, 17033, USA

    Matthew D. Coates

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  1. Matthew D. Coates
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  2. Shannon Dalessio
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  4. August Stuart
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  5. Andrew Tinsley
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  6. Emmanuelle D. Williams
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  7. Kofi Clarke
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Contributions

MC developed the conceptual framework for this study, assisted with and oversaw data collection and analysis in addition to assisting with writing and editing the manuscript. SD assisted with writing and editing the manuscript. VW assisted with data analysis and helped edit the manuscript. AS assisted with data collection and organization, and assisted with editing the manuscript. AT, EW and KC assisted with collection of data, providing the conceptual framework of the study and editing the study.

Corresponding author

Correspondence to Matthew D. Coates.

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Conflicts of interest

The authors of this manuscript have no relevant conflicts of interest or financial disclosures to report.

Ethical approval

This study was performed in accordance with the ethical standards as laid down in the 1964 Declaration of Helsinki and its later amendments and approved by the Pennsylvania State University College of Medicine Institutional Review Board.

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Written informed consent was obtained by all individual participants included in this study.

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Every patient involved in this study signed a consent form to participate in research work that could eventually be published.

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Coates, M.D., Dalessio, S., Walter, V. et al. Lifestyle Factors Associated with Abdominal Pain in Quiescent Inflammatory Bowel Disease. Dig Dis Sci 68, 4156–4165 (2023). https://doi.org/10.1007/s10620-023-08075-0

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