P0520 Association between interoception and Visceral Hypervigilance in patients with Inflammatory Bowel Disease
Authors: Knödler L L , Rösch T , Atanasova K , Ebert M , Thomann A , Reindl W 
Published: January 2025

Abstract

Background
Due to the relapsing course of inflammatory bowel diseases (IBD) with varying disease activity and symptom burden, patients tend to monitor symptoms and bodily sensations to recognize early signs of relapses. Interoception is the ability to perceive and evaluate internal processes of the body. Visceral hypervigilance (VH) describes anxiety and increased attention towards gastrointestinal symptoms. It has been shown to be associated with psychologic comorbidities and reduced quality of life in patients with IBD1, but the factors causing VH are still unknown.
In this study we explored whether changes in interoceptive abilities (accuracy, I-acc; sensibility, I-sens and awareness, I-aw) are associated with VH.

Methods
Adults with IBD (n=34) performed a heartbeat tracking task (Schandry, 1981) for assessment of I-acc and completed questionnaires to assess VH (Visceral Sensitivity Index, VSI) and I-sens. Correlations between I-acc and I-sens were used for an approximation of I-aw. Associations were examined using t-tests and Pearson correlation.

Results
A preliminary examination of the current sample (recruitment is ongoing) showed no significant association between VH and I-acc (r=-0.041; p=0.817) or I-sens (r=0.236; p=0.178). Comparison of a low VH (VSI&lt;20) vs high VH (VSI&gt;40) group showed no significant differences in I-acc or I-sens (VSI&lt;20: n=11; VSI&gt;40: n=9; I-sens: t= -1,183; p= 0,126; I-acc: t= 0,47; p=0,322). Moreover I-aw was not significantly different between a high VH and a low VH group (z=0.218, p=0.828). I-acc and I-sens correlated positively (r=0.374 p = 0.018). VH was strongly correlated with symptoms of anxiety (r=0.659, p&lt;0.001) and depression (r=0.618; p&lt;0.001), but I-acc was not significantly associated with symptoms of anxiety and depression (anxiety r=0.188 p=0.328; depression r=0.067, p=0.729). I-sens was associated with symptoms of anxiety (r= 0.371, p = 0.048), but not with symptoms of depression (r=0.32, p=0.091).

Conclusion
Our preliminary results suggest no associations between VH and objective or subjective interoceptive abilities in patients with IBD. This may be owed to the small sample size with only few patients showing high or low VH. Moreover - even though previous data showed a relationship between perception of cardiac and gastrointestinal signals, and both communicate via the vagal nerve 2-3 - heart-beat tracking may not be the optimal task to measure interoception in patients with IBD. VH and interoception should be examined in larger IBD samples that include individuals with a higher symptom burden. Future studies may also explore further possibilities to assess interoception in IBD patients.

References
1.Thomann AK, Knödler LL, Karthikeyan S, et al. The Interplay of Biopsychosocial Factors and Quality of Life in Inflammatory Bowel Diseases: A Network Analysis. J Clin Gastroenterol. 2023;57(1):57-65. Published 2023 Jan 1. doi:10.1097/MCG.0000000000001625
2.Herbert BM, Muth ER, Pollatos O, Herbert C. Interoception across modalities: on the relationship between cardiac awareness and the sensitivity for gastric functions. PLoS One. 2012;7(5):e36646. doi:10.1371/journal.pone.0036646
3.Whitehead WE, Drescher VM. Perception of gastric contractions and self-control of gastric motility. Psychophysiology. 1980;17(6):552-558. doi:10.1111/j.1469-8986.1980.tb02296.x