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Abdominal Pain After Pediatric Inflammatory Bowel Disease Diagnosis: Results From the ImproveCareNow Network
Lexa K Murphy1, David L Suskind2, Pingping Qu1
1Center for Child Health, Behavior and Development, Seattle Children's Research Institute.
Insights
Abdominal pain is common in pediatric inflammatory bowel disease (IBD) during the first year post-diagnosis. Higher disease severity and psychosocial factors predict ongoing pain, impacting well-being and activity.
Area of Science:
- Pediatric Gastroenterology
- Inflammatory Bowel Disease Research
- Pain Management in Children
Background:
- Abdominal pain is a primary symptom in pediatric inflammatory bowel disease (IBD).
- Limited research exists on pain prevalence and predictors in the initial year post-diagnosis.
- Understanding early pain trajectories is crucial for effective management.
Purpose of the Study:
- To investigate the prevalence, predictors, and impact of abdominal pain within the first 12 months after a pediatric IBD diagnosis.
- To analyze data from the ImproveCareNow (ICN) Network to identify factors associated with persistent pain.
- To inform targeted interventions for pain management in pediatric IBD patients.
Main Methods:
- Analysis of data from 13,875 youth (ages 8-18) diagnosed with IBD within the ICN Network.
- Utilized multivariable mixed effects logistic regression to assess pain presence, activity limitations, and well-being decrements.
- Examined data from 1-22 clinic visits per patient during the first year post-diagnosis.
Main Results:
- Abdominal pain decreased over the first year, but 34% still reported pain at 12 months.
- Predictors of persistent pain included higher disease severity, psychosocial risk factors, and female sex.
- Abdominal pain significantly correlated with reduced well-being and activity limitations, independent of disease severity.
Conclusions:
- Abdominal pain is prevalent and significantly impacts pediatric IBD patients during the first year post-diagnosis.
- Pain's impact persists even when accounting for disease activity.
- Findings support the need for early screening and tailored pain management strategies for pediatric IBD.
Objectives:
Although abdominal pain is a hallmark symptom of pediatric inflammatory bowel disease (IBD), limited research has examined pain during the first year after diagnosis. The purpose of the present study is to examine prevalence, predictors, and impact of abdominal pain during the 12 months after pediatric IBD diagnosis using data from the ImproveCareNow (ICN) Network.
Patients And Methods:
Participants consisted of 13,875 youth (age 8-18 years, 44% female, 81% Caucasian) with IBD (65% Crohn's disease; 27% ulcerative colitis, 8% indeterminate colitis) enrolled in the ICN Network with data from clinic visits during the first year after diagnosis (1-22 visits; mean = 3.7). Multivariable mixed effects logistic regression models were conducted to analyze the presence versus the absence of abdominal pain, activity limitations, and decrements in well-being.
Results:
The percentage of youth reporting abdominal pain decreased significantly during the first year after diagnosis and yet a sizeable group reported continued pain at 12 months (55.9% at diagnosis; 34.0% at 12 months). Multivariable analyses revealed that greater time since diagnosis (odds ratio [OR] = 0.98, P < 0.001), higher disease severity (OR = 11.84, P < 0.001), presence of psychosocial risk factors (OR = 2.33, P = 0.036), and female sex (OR = 1.90, P < 0.010) were significant correlates of continuing abdominal pain. Abdominal pain was significantly associated with decrements in well-being (OR = 5.11, P < 0.001) as well as limitations in activity (OR = 9.31, P < 0.001), over and above the influence of disease severity.
Conclusions:
Abdominal pain is prevalent and impactful, even when controlling for disease activity, during the first year after pediatric IBD diagnosis. Results from the present study can inform screening and tailored pain management intervention efforts in pediatric IBD.
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