Prevalence of chronic pain (CP) is reported as 38% in adult inflammatory bowel disease (IBD), with a significant impact on quality of life (QOL), functional and social outcomes.¹ Prevalence and attributes of CP are unknown in paediatric IBD. Our aim was to evaluate the prevalence, disease related factors, and impact on QOL of CP.

The prospective, cross-sectional single centre study included 41 children, (8–18 years), of a predominantly Crohn’s Disease (CD) cohort 29/41, (70%), (see table 1). Patients and their parents completed validated age-appropriate pain and IMPACT III QOL questionnaires. CP was defined as per von Korff scale.² CP and No pain (NP) medians were compared using Mann-Whitney tests and proportions using Chi squared test (p<0.05).

CP was prevalent in 33/41 (80%) patients. CP subjects were adolescents with extensive and established disease, predominantly on biologics 26/33 (79%). Analgesia use was low 15/33 (45%), with no opiate use. There was no difference in disease activity CP vs NP, defined by PCDAI, PUCAI, CRP and FC. QOL score was significantly lower in CP, with no difference in body image domain score in CP vs NP.

CP is common in paediatric IBD and is not associated with disease activity or related biomarkers. CP significantly impacts emotional, wellbeing and social functioning in children with IBD. This is the first study to report on CP in children with IBD, strategies should target psychosocial interventions. We recommend screening for CP in children with IBD as it is common.

References

1. Morrison G, Van Langenberg DR, Gibson SJ, Gibson PR. Chronic pain in inflammatory bowel disease: characteristics and associations of a hospital-based cohort. Inflamm Bowel Dis. 2013 May;19(6):1210–7.

2. Von Korff M, Ormel J, Keefe FJ, et al. Clinical section: grading the severity of chronic pain. Pain. 1992;50:133–149.