Abdominal Pain After Pediatric Inflammatory Bowel Disease Diagnosis: Results from the ImproveCareNow Network

Background: Although abdominal pain is a hallmark symptom of pediatric inflammatory bowel disease (IBD), limited research has examined pain during the first year after diagnosis. The purpose of this study is to examine prevalence, predictors, and impact of abdominal pain over the 12 months after pediatric IBD diagnosis using data from the ImproveCareNow (ICN) Network.

Methods: Participants consisted of 13,875 youth (age 8-18 years, 44% female, 81% Caucasian) with IBD (65% Crohn's disease; 27% ulcerative colitis, 8% indeterminate colitis) enrolled in the ICN Network with data from clinic visits during the first year after diagnosis (1-22 visits; Mean=3.7). Multivariable mixed effects logistic regression models were conducted to analyze presence vs. absence of abdominal pain, activity limitations, and decrements in wellbeing.

Results: The percentage of youth reporting abdominal pain decreased significantly during the first year after diagnosis yet a sizeable group reported continued pain at 12 months (55.9% at diagnosis; 34.0% at 12 months). Multivariable analyses revealed that greater time since diagnosis (OR=0.98, p<.001), higher disease severity (OR=11.84, p<.001), presence of psychosocial risk factors (OR=2.33, p=.036), and female sex (OR=1.90, p<.010) were significant correlates of continuing abdominal pain. Abdominal pain was significantly associated with decrements in wellbeing (OR=5.11, p<.001) as well as limitations in activity (OR=9.31, p<.001), over and above the influence of disease severity.

Conclusions: Abdominal pain is prevalent and impactful, even when controlling for disease activity, during the first year after pediatric IBD diagnosis. Results from this study can inform screening and tailored pain management intervention efforts in pediatric IBD.