Abstract Background Inflammatory bowel disease (IBD) is a chronic relapsing and remitting disease, frequently causing abdominal pain. The gut-brain axis provides an extensive framework to understand the relationship between IBD and psychological well-being. Accumulating evidence indicates that prolonged psychological stress may worsen IBD symptoms and recurrence. Resilience factors (eg, optimism, self-efficacy, mindfulness) are associated with improved outcomes in other populations with recurrent pain; however, it has not been investigated in adolescent IBD populations. Aims To examine the association between resilience factors and abdominal pain intensity in adolescents with IBD. Methods A cross-sectional study of 70 adolescents (aged 12-17 years) with IBD (51% male, 47% in clinical remission) was conducted. Multivariable hurdle models were used to predict the presence and degree of pain. In conditional models, all variables were adjusted for age and sex. Results In all models, disease activity and optimism were significant predictors of pain presence (OR 0.92 95% CI, 0.85-0.99). In unconditional models, sex was associated with degree of pain. Predicted pain intensity was 1.37 times greater for females than males. Sex was not significantly associated with pain presence. Increased clinical disease activity, lower optimism, and lower mindfulness scores were associated with pain presence in adolescents with IBD. Conclusions Our findings support an association between clinical disease activity, optimism, mindfulness, and pain. These results highlight the potential benefits of incorporating resilience-based pain management strategies alongside clinical disease assessment and treatment for adolescents with IBD.
Benchimol et al. (Fri,) studied this question.