Abdominal pain in patients with inflammatory bowel disease: association with single-nucleotide polymorphisms prevalent in irritable bowel syndrome and clinical management
Authors: Ledergerber Martina , Lang Brian M. , Heinrich Henriette , Biedermann Luc , Begré Stefan , Zeitz Jonas , Krupka Niklas , Rickenbacher Andreas , Turina Matthias , Greuter Thomas , Schreiner Philipp , Roth René , Siebenhüner Alexander , Vavricka Stephan R. , Rogler Gerhard , Beerenwinkel Niko , Misselwitz Benjamin ,   the Swiss IBD Cohort Study Group, Anderegg Claudia , Bauerfeind Peter , Beglinger Christoph , Begré Stefan , Belli Dominique , Bengoa José M. , Biedermann Luc , Bigler Beat , Binek Janek , Blattmann Mirjam , Boehm Stephan , Borovicka Jan , Braegger Christian P. , Brunner Nora , Bühr Patrick , Burnand Bernard , Burri Emanuel , Buyse Sophie , Cremer Matthias , Criblez Dominique H. , de Saussure Philippe , Degen Lukas , Delarive Joakim , Doerig Christopher , Dora Barbara , Dorta Gian , Egger Mara , Ehmann Tobias , El-Wafa Ali , Engelmann Matthias , Ezri Jessica , Felley Christian , Fliegner Markus , Fournier Nicolas , Fraga Montserrat , Frei Pascal , Frei Remus , Fried Michael , Froehlich Florian , Funk Christian , Furlano Raoul Ivano , Gallot-Lavallée Suzanne , Geyer Martin , Girardin Marc , Golay Delphine , Grandinetti Tanja , Gysi Beat , Haack Horst , Haarer Johannes , Helbling Beat , Hengstler Peter , Herzog Denise , Hess Cyrill , Heyland Klaas , Hinterleitner Thomas , Hiroz Philippe , Hirschi Claudia , Hruz Petr , Iwata Rika , Jost Res , Juillerat Pascal , Brondolo Vera Kessler , Knellwolf Christina , Knoblauch Christoph , Köhler Henrik , Koller Rebekka , Krieger-Grübel Claudia , Kullak-Ublick Gerd , Künzler Patrizia , Landolt Markus , Lange Rupprecht , Lehmann Frank Serge , Macpherson Andrew , Maerten Philippe , Maillard Michel H. , Manser Christine , Manz Michael , Marbet Urs , Marx George , Matter Christoph , McLin Valérie , Meier Rémy , Mendanova Martina , Meyenberger Christa , Michetti Pierre , Misselwitz Benjamin , Moradpour Darius , Morell Bernhard , Mosler Patrick , Mottet Christian , Müller Christoph , Müller Pascal , Müllhaupt Beat , Münger-Beyeler Claudia , Musso Leilla , Nagy Andreas , Neagu Michaela , Nichita Cristina , Niess Jan , Noël Natacha , Nydegger Andreas , Obialo Nicole , Oneta Carl , Oropesa Cassandra , Peter Ueli , Peternac Daniel , Petit Laetitia Marie , Piccoli-Gfeller Franziska , Pilz Julia Beatrice , Pittet Valérie , Raschle Nadia , Rentsch Ronald , Restellini Sophie , Richterich Jean-Pierre , Rihs Sylvia , Ritz Marc Alain , Roduit Jocelyn , Rogler Daniela , Rogler Gerhard , Rossel Jean-Benoît , Sagmeister Markus , Saner Gaby , Sauter Bernhard , Sawatzki Mikael , Schäppi Michela , Scharl Michael , Schelling Martin , Schibli Susanne , Schlauri Hugo , Uebelhart Sybille Schmid , Schnegg Jean-François , Schoepfer Alain , Seibold Frank , Seirafi Mariam , Semadeni Gian-Marco , Semela David , Senning Arne , Sidler Marc , Sokollik Christiane , Spalinger Johannes , Spangenberger Holger , Stadler Philippe , Steuerwald Michael , Straumann Alex , Straumann-Funk Bigna , Sulz Michael , Thorens Joël , Tiedemann Sarah , Tutuian Radu , Vavricka Stephan , Viani Francesco , Vögtlin Jürg , Von Känel Roland , Vonlaufen Alain , Vouillamoz Dominique , Vulliamy Rachel , Wermuth Jürg , Werner Helene , Wiesel Paul , Wiest Reiner , Wylie Tina , Zeitz Jonas , Zimmermann Dorothee 
Published: February 2021

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.