Year 2025 / Volume 117 / Number 11
Letter
Ulcerative colitis in remission symptoms: a response to anxiety or ongoing inflammation?

679-680

DOI: 10.17235/reed.2024.10695/2024

Andrea Silva, Maria José Temido, Joana Madeira, Mariana Sant’Anna, Sandra Lopes, Mário Rui Silva, Pedro Figueiredo, Francisco Portela,

Abstract
Introduction: Understand the cause of gastrointestinal symptoms compatible with irritable bowel syndrome (IBS) in patients with inflammatory bowel disease (IBD) in remission is challenging. Those patients are known to show more anxiety, that may influence the course of IBD. The aim of this study was to determine the prevalence of IBS-like symptoms and anxiety by a questionnaire, and his association with subclinical inflammation using calprotectin levels (FC), Mayo Endoscopic Score (MES) and Geboes score (GS) in patients with ulcerative colitis (UC) in clinical remission. Methods: Recruitment occurred between January 2020 and December 2021 and included UC patients scheduled for colonoscopy. Clinical remission was defined by stool frequency, ulcerative colitis activity index and serum C-reactive protein. IBS diagnosis was evaluated by Roma IV criteria. Results: We included 106 patients (51.9% women; mean age 51 years ±14.8). Rome IV criteria were fulfilled by 29 patients (27.4%). In the UC+IBS group more individuals had calprotectin >100mg/Kg (58.6% vs 23.4%, P=0.001), MES≥1 (37.9% vs 16.9%, P=0.023) and GS>2 (69.0% vs 29.9%, P=0.000). Thirty-three patients reported anxiety (31.3%). UC+IBS group also showed higher anxiety rates (51.7% vs 23.4, P=0.006). In multivariate logistic regression analyses: FC>100mg/Kg, histological activity, and higher anxiety were associated with IBS-like symptoms. Conclusion: IBS-like symptoms are common in UC patients considered in clinical remission and relates with anxiety and subclinical inflammation. Our findings underscore the necessity for a comprehensive strategy for these patients, targeting not only inflammation but also psychological conditions.
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Silva A, Temido M, Madeira J, Sant’Anna M, Lopes S, Silva M, et all. Ulcerative colitis in remission symptoms: a response to anxiety or ongoing inflammation?. 10695/2024


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Publication history

Received: 31/07/2024

Accepted: 31/07/2024

Online First: 05/09/2024

Published: 11/11/2025

Article Online First time: 36 days

Article editing time: 468 days


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