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Published on: November 30, 2016
Pain patterns in patients with irritable bowel symptoms - A longitudinal observational time series approach
B Wild1, T Stadnitski2, S Benz-Sahnoun1
1Department of General Internal Medicine and Psychosomatics, University Hospital Heidelberg, Germany.
Background:
Patients with IBS frequently present with a long history of abdominal pain, and high psychosocial burden. The aim of this study was to analyze pain patterns of IBS patients and to identify different pain phenotypes.
Methods:
The study used a longitudinal design. At the beginning IBS patients filled in a series of validated questionnaires. Subsequently, during 7 weeks n = 81 patients answered questions daily regarding somatic and psychological variables using an online diary. Cluster analysis was applied to determine pain phenotypes. Vector autoregressive modelling (VAR) was used to analyze the diary data.
Results:
Three groups could be determined according to their pain patterns: high persistent pain (HPP), occasional pain (OP), and moderate changing pain (MCP). Pain phenotypes were independent of gender and age and occurred across all IBS subtypes. The OP group scored significantly lower (p < .05) in psychosomatic burden compared to the other two groups. The HPP group exhibited the highest levels across all psychosomatic symptoms with significant differences to the OP group. However, HPP did not differ from the MCP group regarding all psychosomatic questionnaire scores, except for hypochondriasis. Diary data showed that, all concurrent correlations between abdominal pain, depression, and anxiety were significant, ranging from 0.24 to 0.62, Lagged correlations between abdominal pain and psychological times series were observed in 35 % of the patients, with no differences between the three groups.
Conclusion:
We identified three different pain phenotypes in IBS patients. Further studies could explore whether the three pain phenotypes would benefit from different treatment approaches.
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