Pain in Patients With Crohn Disease (PAINCD)

Study Overview
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Brief Summary
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Abdominal pain is a common symptom in patients with Crohn disease (CD). Pain is multifactorial, may result from inflammation but persists in many patients during remission. The aim of our study is to determine the epidemiology of pain in CD patients and define the characteristics of pain : localisation, temporal and sensorial characteristics, neuropathic component, impact on quality of life and mood.

Detailed Description
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Abdominal pain is a common symptom in patients with inflammatory bowel disease (IBD) that alters quality of life and can lead to increased healthcare utilization. In addition to abdominal pain, pain can result from extra-intestinal manifestation of IBD. 40% of IBD patients suffer from extra-intestinal manifestations. Although abdominal pain has been traditionally attributed to inflammation, functional abdominal pain exists in patients with IBD, associated with a variety of potential causes. About 20-40% of patients in complete clinical and endoscopic remission continue to experience chronic pain. Thus, when examining an IBD patient with abdominal pain, in addition to IBD-related complications (e.g., inflammation, stricture), it is important to screen for other contributors, including peripheral factors (visceral hypersensitivity, bacterial overgrowth, and bowel dysmotility) and centrally mediated neurobiological and psychosocial underpinnings. These central factors include psychological symptoms, sleep disturbance, and stress. Opioid-induced hyperalgesia (e.g., narcotic bowel syndrome) is also growing in recognition as a potential central source of abdominal pain. Pronounced severe pain impacts health related quality of life (QoL). Longstanding pain leads to decreased QoL, increase in pain medication intake, and co-morbidities including depression, anxiety and even addiction. Furthermore, pain attacks severely interfere with social and professional life. Knowledge of these potential aetiologies should be used to individualize treatment of abdominal pain in patients with IBD. Accurate assessment of the source of pain can help guide appropriate diagnosis workup and use of modifying therapy. The aim of the study is to determine the epidemiology of pain in patients with Crohn disease (CD) and to characterize their pain (localisation, temporal characteristics, acute vs. chronic, sensorial characteristics, existence of neuropathic component, existence of hyperalgesia), and their impact of QoL, depression and anxiety

Official Title
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Epidemiology and Characterization of Pain in Patients With Crohn Disease

Conditions
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Crohn Disease, Pain, Depression, Anxiety

Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: any patient with Crohn disease in remission or relapse period age ≥ 18 yo. Exclusion Criteria: No exclusion criteria beside no informed consent and inadequate French language skills

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Pain intensity in patients with Crohn Disease (CD) | Pain intensity measured using a 100 mm visual analog scale (0 = no pain; 100 the worst imaginable pain) | During the last 30 days | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Presence of hyperalgesia | Using Von Frey hairs (size 2.83 for dectection of allodynia; size 6.65 for temporal somation) | During the last 30 days | 
| Search for a neuropathic component of pain | Using DN-4 questionnaires : a score ≥ 3 = neuropathic component | During the last 30 days | 
| Investigation of the impact of pain on depression and anxietey | Using the HAD (Hospital anxiety depression) scale : as score > 11 = true symptomatology | During the last 30 days | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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crohn disease, pain