Martina Ledergerber1, Brian M Lang2,3, Henriette Heinrich1, Luc Biedermann1, Stefan Begré4, Jonas Zeitz1,5, Niklas Krupka6, Andreas Rickenbacher7, Matthias Turina7, Thomas Greuter1, Philipp Schreiner1, René Roth1, Alexander Siebenhüner8, Stephan R Vavricka1, Gerhard Rogler1, Niko Beerenwinkel2,3, Benjamin Misselwitz9,10. 1. Department of Gastroenterology, University Hospital Zurich (USZ), Zurich University, Zurich, Switzerland. 2. Department of Biosystems Science and Engineering, ETH Basel, Basel, Switzerland. 3. SIB Swiss Institute of Bioinformatics, Basel, Switzerland. 4. Department of Biomedical Research, Neurology, Inselspital and University Clinic of Bern, Bern, Switzerland. 5. Center of Gastroenterology, Clinic Hirslanden, Zurich, Switzerland. 6. Department of Visceral Surgery and Medicine, Inselspital Bern, University of Bern, Bern, Switzerland. 7. Department of Visceral Surgery, University Hospital Zurich (USZ), Zurich, Switzerland. 8. Department of Oncology, Center of Hematology and Oncology University Hospital Zurich (USZ), Zurich University, Zurich, Switzerland. 9. Department of Gastroenterology, University Hospital Zurich (USZ), Zurich University, Zurich, Switzerland. benjamin.misselwitz@insel.ch. 10. Department of Visceral Surgery and Medicine, Inselspital Bern, University of Bern, Bern, Switzerland. benjamin.misselwitz@insel.ch.
Abstract
BACKGROUND: Abdominal pain is a frequent symptom in patients with inflammatory bowel disease (IBD) including Crohn's disease (CD) and ulcerative colitis (UC). Pain can result from ongoing inflammation or functional disorders imitating irritable bowel syndrome (IBS). Several single-nucleotide polymorphisms (SNPs) have been associated with IBS. However, the impact of IBS genetics on the clinical course of IBD, especially pain levels of patients remains unclear. METHODS: Data of 857 UC and 1206 CD patients from the Swiss IBD Cohort Study were analysed. We tested the association of the maximum of the abdominal pain item of disease activity indices in UC and CD over the study period with 16 IBS-associated SNPs, using multivariate ANOVA models. RESULTS: In UC patients, the SNPs rs1042713 (located on the ADRB2 gene) and rs4663866 (close to the HES6 gene) were associated with higher abdominal pain levels (P = 0.044; P = 0.037, respectively). Abdominal pain was not associated with any markers of patient management in a model adjusted for confounders. In CD patients, higher levels of abdominal pain correlated with the number of physician contacts (P < 10-15), examinations (P < 10-12), medical therapies (P = 0.023) and weeks of hospitalisation (P = 0.0013) in a multivariate model. CONCLUSIONS: We detected an association between maximal abdominal pain in UC patients and two IBS-associated SNPs. Abdominal pain levels had a pronounced impact on diagnostic and therapeutic procedures in CD but not in UC patients.
BACKGROUND:Abdominal pain is a frequent symptom in patients with inflammatory bowel disease (IBD) including Crohn's disease (CD) and ulcerative colitis (UC). Pain can result from ongoing inflammation or functional disorders imitating irritable bowel syndrome (IBS). Several single-nucleotide polymorphisms (SNPs) have been associated with IBS. However, the impact of IBS genetics on the clinical course of IBD, especially pain levels of patients remains unclear. METHODS: Data of 857 UC and 1206 CD patients from the Swiss IBD Cohort Study were analysed. We tested the association of the maximum of the abdominal pain item of disease activity indices in UC and CD over the study period with 16 IBS-associated SNPs, using multivariate ANOVA models. RESULTS: In UC patients, the SNPs rs1042713 (located on the ADRB2 gene) and rs4663866 (close to the HES6 gene) were associated with higher abdominal pain levels (P = 0.044; P = 0.037, respectively). Abdominal pain was not associated with any markers of patient management in a model adjusted for confounders. In CD patients, higher levels of abdominal pain correlated with the number of physician contacts (P < 10-15), examinations (P < 10-12), medical therapies (P = 0.023) and weeks of hospitalisation (P = 0.0013) in a multivariate model. CONCLUSIONS: We detected an association between maximal abdominal pain in UC patients and two IBS-associated SNPs. Abdominal pain levels had a pronounced impact on diagnostic and therapeutic procedures in CD but not in UC patients.
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