Increased chronic pain in patients with ulcerative colitis is mostly associated to increased disease activity. A cross-sectional case-control study

Abstract

Backgrounds/aims

Musculoskeletal symptoms are common in patients with ulcerative colitis (UC), but no study has compared the prevalence of chronic pain to controls from a general population.

Methods

Patients with UC (n = 1164) and controls (n = 3867) were sent questionnaires comprising demography, history of pain, pain localization and UC patients’ Patient-Simple Clinical Colitis Activity Index. Chronic regional pain (ChRP) and chronic widespread pain (ChWP) were defined as having pain for at least 3 months.

Results

The response rate for the patients with UC was 49.0% and for the control persons 61.7% (p < .001). The reported prevalence of ChRP and ChWP was higher in patients with UC versus controls (33.1% vs. 24.2%; p < .001 and 19.8% vs. 12.5%; p < .001). The patients with UC reported significantly more pain in the regions ‘lower back’, ‘hip/upper leg’ and ‘lower leg/foot’ compared to controls. The patients with P-SCCAI $\ge$5 (n = 121) reported more ChWP than patients with P-SCCAI <5 (n = 426) (46.3% vs. 12.7%; p < .001) and controls (n = 2425) (46.3 vs. 12.5%; p < .001) in all body regions. No significant difference in ChWP was found between patients with P-SCCAI <5 and controls (12.7% vs. 12.5%; p = .917).

Conclusions

Patients with UC reported more chronic pain than controls from the general population, especially from the lower back and hip region. Higher UC disease activity was associated with more pain in all body regions.

Keywords:

• Musculoskeletal pain
• spondyloarthritis ulcerative colitis
• inflammatory bowel disease
• chronic pain

Acknowledgements

The authors thank the health care regions of Västernorrland and Västerbotten, Sweden.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Author contributions

N.P. and F.K. participated in designing the study, collecting the data, performing statistical analyses, interpreting the results. A.W. contributed to collecting the data and critically reviewed the final manuscript. S.B. participated in the analysis. P.K. and H.F.d.E. participated in designing the study, collecting the data, performing statistical analyses, interpreting the results and in writing the manuscript. All authors have read and approved the final manuscript.

Additional information

Funding

This work was supported by Umeå University.