Tags

Type your tag names separated by a space and hit enter

The prevalence of irritable bowel syndrome-type symptoms in paediatric inflammatory bowel disease, and the relationship with biochemical markers of disease activity.
Aliment Pharmacol Ther 2016; 44(2):181-8AP

Abstract

BACKGROUND

A large proportion (25-46%) of adults with inflammatory bowel disease in remission has symptoms of irritable bowel syndrome (IBS), which are thought to reflect ongoing inflammation. Data on paediatric inflammatory bowel disease patients are lacking.

AIM

To investigate (i) the prevalence of IBS-type symptoms in paediatric inflammatory bowel disease patients in remission and (ii) the relationship of IBS-type symptoms with biochemical markers of disease activity.

METHODS

This cross-sectional study included all patients (<18 years) with Crohn's disease or ulcerative colitis attending the out-patient clinic of one of three Dutch hospitals between March 2014 and June 2015. Clinical disease activity was determined using the abbreviated-PCDAI or PUCAI. Biochemical disease activity was assessed using faecal calprotectin and serum CRP. IBS-symptoms were assessed using physician-administered Rome III-questionnaires.

RESULTS

We included 184 patients (92 female; mean age: 14.5 years) (Crohn's disease: 123, ulcerative colitis: 61). The prevalence of IBS-type symptoms in children with inflammatory bowel disease in clinical remission was 6.4% (95% CI: 2.5-11.1%; Crohn's disease: 4.5%; ulcerative colitis: 10.8%). Prevalence of IBS-type symptoms in children with faecal calprotectin <250 μg/g was 16.1% (95% CI: 7.6-25.8%; Crohn's disease: 16.7%; ulcerative colitis: 10.8%). No difference in faecal calprotectin or CRP was found between patients in clinical remission with or without IBS-type symptoms (faecal calprotectin: IBS+ median 58 μg/g, IBS- 221 μg/g, P = 0.12; CRP: IBS+ median 1.4 mg/L, IBS- 1.1 mg/L, P = 0.63).

CONCLUSIONS

The prevalence of IBS-type symptoms in children with inflammatory bowel disease is highly dependent on the definition of remission. Nonetheless, the prevalence is much lower than that previously reported in studies in adult inflammatory bowel disease patients. IBS-type symptoms appear to be unrelated to gastrointestinal inflammation.

Authors+Show Affiliations

Department of Pediatric Gastroenterology and Nutrition, Emma Children's Hospital/Academic Medical Center, Amsterdam, The Netherlands.Department of Pediatric Gastroenterology and Nutrition, Emma Children's Hospital/Academic Medical Center, Amsterdam, The Netherlands.Department of Pediatrics, Medisch Spectrum Twente, Enschede, The Netherlands.Department of Pediatric Gastroenterology, VU University Medical Center, Amsterdam, The Netherlands.Department of Pediatric Gastroenterology and Nutrition, Emma Children's Hospital/Academic Medical Center, Amsterdam, The Netherlands.Department of Pediatric Gastroenterology and Nutrition, Emma Children's Hospital/Academic Medical Center, Amsterdam, The Netherlands.Department of Pediatrics, St Antonius Ziekenhuis, Nieuwegein, The Netherlands.Department of Pediatric Gastroenterology and Nutrition, Emma Children's Hospital/Academic Medical Center, Amsterdam, The Netherlands.Department of Pediatric Gastroenterology and Nutrition, Emma Children's Hospital/Academic Medical Center, Amsterdam, The Netherlands.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

27110920

Citation

Diederen, K, et al. "The Prevalence of Irritable Bowel Syndrome-type Symptoms in Paediatric Inflammatory Bowel Disease, and the Relationship With Biochemical Markers of Disease Activity." Alimentary Pharmacology & Therapeutics, vol. 44, no. 2, 2016, pp. 181-8.
Diederen K, Hoekman DR, Hummel TZ, et al. The prevalence of irritable bowel syndrome-type symptoms in paediatric inflammatory bowel disease, and the relationship with biochemical markers of disease activity. Aliment Pharmacol Ther. 2016;44(2):181-8.
Diederen, K., Hoekman, D. R., Hummel, T. Z., de Meij, T. G., Koot, B. G., Tabbers, M. M., ... Benninga, M. A. (2016). The prevalence of irritable bowel syndrome-type symptoms in paediatric inflammatory bowel disease, and the relationship with biochemical markers of disease activity. Alimentary Pharmacology & Therapeutics, 44(2), pp. 181-8. doi:10.1111/apt.13636.
Diederen K, et al. The Prevalence of Irritable Bowel Syndrome-type Symptoms in Paediatric Inflammatory Bowel Disease, and the Relationship With Biochemical Markers of Disease Activity. Aliment Pharmacol Ther. 2016;44(2):181-8. PubMed PMID: 27110920.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The prevalence of irritable bowel syndrome-type symptoms in paediatric inflammatory bowel disease, and the relationship with biochemical markers of disease activity. AU - Diederen,K, AU - Hoekman,D R, AU - Hummel,T Z, AU - de Meij,T G, AU - Koot,B G P, AU - Tabbers,M M, AU - Vlieger,A M, AU - Kindermann,A, AU - Benninga,M A, Y1 - 2016/04/25/ PY - 2016/02/12/received PY - 2016/02/29/revised PY - 2016/03/17/revised PY - 2016/03/30/revised PY - 2016/03/30/accepted PY - 2016/4/26/entrez PY - 2016/4/26/pubmed PY - 2017/8/19/medline SP - 181 EP - 8 JF - Alimentary pharmacology & therapeutics JO - Aliment. Pharmacol. Ther. VL - 44 IS - 2 N2 - BACKGROUND: A large proportion (25-46%) of adults with inflammatory bowel disease in remission has symptoms of irritable bowel syndrome (IBS), which are thought to reflect ongoing inflammation. Data on paediatric inflammatory bowel disease patients are lacking. AIM: To investigate (i) the prevalence of IBS-type symptoms in paediatric inflammatory bowel disease patients in remission and (ii) the relationship of IBS-type symptoms with biochemical markers of disease activity. METHODS: This cross-sectional study included all patients (<18 years) with Crohn's disease or ulcerative colitis attending the out-patient clinic of one of three Dutch hospitals between March 2014 and June 2015. Clinical disease activity was determined using the abbreviated-PCDAI or PUCAI. Biochemical disease activity was assessed using faecal calprotectin and serum CRP. IBS-symptoms were assessed using physician-administered Rome III-questionnaires. RESULTS: We included 184 patients (92 female; mean age: 14.5 years) (Crohn's disease: 123, ulcerative colitis: 61). The prevalence of IBS-type symptoms in children with inflammatory bowel disease in clinical remission was 6.4% (95% CI: 2.5-11.1%; Crohn's disease: 4.5%; ulcerative colitis: 10.8%). Prevalence of IBS-type symptoms in children with faecal calprotectin <250 μg/g was 16.1% (95% CI: 7.6-25.8%; Crohn's disease: 16.7%; ulcerative colitis: 10.8%). No difference in faecal calprotectin or CRP was found between patients in clinical remission with or without IBS-type symptoms (faecal calprotectin: IBS+ median 58 μg/g, IBS- 221 μg/g, P = 0.12; CRP: IBS+ median 1.4 mg/L, IBS- 1.1 mg/L, P = 0.63). CONCLUSIONS: The prevalence of IBS-type symptoms in children with inflammatory bowel disease is highly dependent on the definition of remission. Nonetheless, the prevalence is much lower than that previously reported in studies in adult inflammatory bowel disease patients. IBS-type symptoms appear to be unrelated to gastrointestinal inflammation. SN - 1365-2036 UR - https://www.unboundmedicine.com/medline/citation/27110920/The_prevalence_of_irritable_bowel_syndrome_type_symptoms_in_paediatric_inflammatory_bowel_disease_and_the_relationship_with_biochemical_markers_of_disease_activity_ L2 - https://doi.org/10.1111/apt.13636 DB - PRIME DP - Unbound Medicine ER -