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BEYOND INFLAMMATION: PSYCHOLOGICAL &AMP; PHYSIOLOGICAL DETERMINANTS OF CHRONIC PAIN SEVERITY AND INTERFERENCE IN IBD REMISSION

Pavit Luthra 1, Ruqaya Idrees 1, Reuma Yehuda Margalit 1, Iman Khwaja 1, Miles Parkes 2, Ailsa L Hart 3, Christine Norton 4, Harry Sokol 5, Nathalie Vergnolle 6, David Bulmer 7, James O. Lindsay 8, Qasim Aziz 9

Affiliations

1 Wingate Institute of Neurogastroenterology, Queen Mary University of London, London, United Kingdom

2 Inflammatory Bowel Disease Research Group, Addenbrooke's Hospital, Cambridge, United Kingdom

3 St Mark’s Hospital and Academic Institute, Harrow, United Kingdom

4 King's College London, London, United Kingdom

5 Saint-Antoine Hospital, Paris, France

6 INSERM UMR-1220, Toulouse, France

7 University of Cambridge, Cambridge, United Kingdom

8 Blizard Institute, Queen Mary University of London, London, United Kingdom

9 Wingate Institute for Neurogastroenterology - Centre for Neuroscience and Trauma, London, United Kingdom

Summary

AI Generated

In a cross-sectional study of 1445 adults with IBD in remission, 26.4% experienced chronic abdominal pain, with pain severity and interference most strongly correlated with somatic symptom burden, fatigue, depression, and maladaptive behavioural responses.

Among 1445 patients meeting remission criteria (Harvey-Bradshaw Index <5 for CD, Simple Clinical Colitis Activity Index ≤2 for UC), 381 (26.4%) met Rome IV criteria for chronic abdominal pain (pain ≥1 day/week for ≥3 months).
Somatic symptom burden showed the strongest correlations with both pain severity (rs=0.47) and pain interference (rs=0.52), explaining 27% of variance in pain interference.
Fatigue, depression, and sleep disturbance were significantly associated with pain outcomes, alongside maladaptive cognitive-behavioural responses including fear-avoidance, resting behaviour, and symptom focusing.
Pain interference showed stronger correlations than pain severity across psychological and behavioural domains including anxiety, neuroticism, low sensory threshold, and resilience.
The authors conclude that these findings support a biopsychosocial care model and integrated gut-brain axis targeted interventions including cognitive-behavioural therapy and neuromodulation for patients with chronic abdominal pain in IBD remission.

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Abstract

Introduction

Chronic abdominal pain (CAP) affects 20-50% of patients with Inflammatory Bowel Disease (IBD) despite clinical remission. CAP in the absence of active inflammation suggests altered pain processing and gut-brain axis (GBA) dysregulation. This study explores psychological, physiological and behavioural contributors to inform integrated GBA targeted care.

Aims & Methods

This cross-sectional analysis of 2525 adults with Crohn’s disease (CD) or Ulcerative colitis (UC) recruited from the UK IBD-Bioresource (December 2022-April 2024). 1445 met remission criteria (Harvey-Bradshaw Index <5 for CD, and Simple Clinical Colitis Activity Index ≤2 for UC). CAP was defined using Rome IV criteria as abdominal pain ≥1 day/week for ≥3 months. Pain severity and interference (Brief Pain Inventory) were correlated with psychological (PHQ-15 [somatization], PHQ-9 [depression], GAD-7 [anxiety]), physiological (PROMIS fatigue/PROMIS sleep disturbance), cognitive-behavioural (CBRQ), sensory sensitivity (HSP-SP), personality (BFQ) and resilience (CD-RISC) measures using Spearman’s rank correlation.

Results

Among 1445 patients in remission (mean age: 53±16 years; 48.3% female), 381 (26.4%) met CAP criteria (mean age: 49±14.63 years; 57% female; 61.7% CD;). Pain severity and interference were most strongly associated with somatic symptom burden (r_s=0.47 and r_s=0.52; p<0.0001). Fatigue, depression and sleep disturbance were also significant, alongside maladaptive behaviours including fear-avoidance and resting in response to pain (table 1). Somatic symptom burden explained 27% of the variance in pain interference. Pain severity showed modest associations with age (r_s=0.15, p=0.004) and BMI (r_s=0.15, p=0.006). ). Disease duration was not significantly associated with pain outcomes. Patients with CD reported greater pain interference than those with UC (median =0.432, p=0.016).
Pain interference showed stronger corelations than severity across psychological and behavioural domains, including anxiety (r_s=0.34), symptom focusing (r_s=0.30), neuroticism (r_s=0.28), low sensory threshold (r_s=0.20), and resilience (r_s=–0.24) (all p<0.0001). These interconnected factors reflect shared biopsychosocial mechanisms underlying CAP in IBD during remission.

Table 1. Key Correlates of Chronic Abdominal Pain: Pain severity and Pain interference in IBD Remission

Domain	Pain severity (r_s) (95% CI)	p-value*	Pain interference (r_s) (95% CI)	p-value*
Somatic symptoms (PHQ-15)	0.47 (0.38-0.55)	<0.0001	0.52 (0.44-0.60)	<0.0001
Depression (PHQ-9)	0.28 (0.18-0.38)	<0.0001	0.48 (0.39-0.55)	<0.0001
Anxiety (GAD-7)	0.12 (0.01-0.22)	0.0255	0.34 (0.24-0.43)	<0.0001
Fatigue (PROMIS)	0.34 (0.22-0.44)	<0.0001	0.49 (0.40-0.57)	<0.0001
Sleep disturbance (PROMIS)	0.27 (0.14-0.39)	<0.0001	0.21 (0.08-0.34)	0.0014
Fear avoidance (CRBQ) Symptom focusing (CRBQ) All-or-nothing behaviour (CRBQ) Resting behaviour (CRBQ)	0.29 (0.19-0.39) 0.15 (0.05-0.25) 0.19 (0.09-0.29) 0.21 (0.10-0.31)	<0.0001 0.004 0.0003 <0.0001	0.30 (0.19-0.39) 0.30 (0.20-0.40) 0.25 (0.15-0.35) 0.28 (0.18-0.38)	<0.0001 <0.0001 <0.0001 <0.0001
Low sensitivity threshold (HSPS-SF)	0.15 (0.04-0.25)	0.2566	0.20 (0.10-0.30)	0.0001
Neuroticism (BFQ)	0.06 (-0.05-0.17)	0.252	0.28 (0.17-0.37)	<0.001
Resilience (CD-RISC)	-0.06 (-0.17-0.05)	0.2566	-0.24 (-0.34- -0.14)	<0.0001

*p-value significance level <0.01
Abbreviations: PHQ-15: Patient Health Questionnaire-15, PHQ-9: Patient Health Questionnaire-9, GAD-7: Generalized Anxiety Disorder Assessment-7, PROMIS: Patient-Reported Outcomes Measurement Information System, PROMIS: Patient-Reported Outcomes Measurement Information System, HSP-SF: Highly Sensitive Person Scale – Short Form, BFQ: Big Five Personality Questionnaire, CD-RISC: Connor-Davidson Resilience Scale.

Conclusion

CAP in IBD during remission involves complex GBA dysregulation encompassing somatic, emotional and behavioural factors. These findings support a biopsychosocial care model and highlight the need for integrated GBA targeted interventions, including cognitive-behavioural therapy and neuromodulation.

Conference

UEG Week Berlin 2025

Topics

IBD

Submission format

Abstract

Session

Patient-reported outcome and quality of life in IBD (Posters)

Citation

United European Gastroenterology Journal 2025; 13 (Supplement 8)

Published

2025

More Like This:

RISK OF RELAPSE AFTER CESSATION OF ANTI-TNF THERAPY IN ULCERATIVE COLITIS IN CORTICOSTEROID-FREE CLINICAL REMISSION: AN INDIVIDUAL PARTICIPANT DATA META-ANALYSIS (IPD-MA) ON 654 PATIENTS FROM 8 STUDIES

Gionata Fiorino

The treatment

Judith Wellens

How to boost your biology? Every day strategies to improve therapies and combinations

Britta Siegmund

INFLAMMAGEING AND RISK OF DIGESTIVE SYSTEM DISEASES: A LARGE COHORT STUDY BASED ON THE UK BIOBANK

Yan Qin

Introduction: The Crohn´s disease journey

Ailsa L Hart

DIGESTIVE ULTRASOUND: A KEY TOOL IN CROHN'S DISEASE MONITORING

Walid boukamza

UEG Presentation

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RISK OF RELAPSE AFTER CESSATION OF ANTI-TNF THERAPY IN ULCERATIVE COLITIS IN CORTICOSTEROID-FREE CLINICAL REMISSION: AN INDIVIDUAL PARTICIPANT DATA META-ANALYSIS (IPD-MA) ON 654 PATIENTS FROM 8 STUDIES

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RISK OF RELAPSE AFTER CESSATION OF ANTI-TNF THERAPY IN ULCERATIVE COLITIS IN CORTICOSTEROID-FREE CLINICAL REMISSION: AN INDIVIDUAL PARTICIPANT DATA META-ANALYSIS (IPD-MA) ON 654 PATIENTS FROM 8 STUDIES

Monique Devillers 1, Sebastiaan ten Bokkel Huinink 1, Toby Hackmann 2, Ewout Steyerberg 3, Bas Oldenburg 4, Remi Mahmoud 4, Pauliina Molander 5, Klaudia Farkas 6, Gionata Fiorino 7, María Chaparro 8, Javier Gisbert 8, María José Casanova 8, Sung-Noh Hong 9, Nikolas Dussias 10, Annemarie de Vries 1

Affiliations

1 Erasmus MC University Medical Center, Rotterdam, Netherlands

2 Leiden University Medical Center, Leiden, Netherlands

3 Utrecht University Medical Center, Utrecht, Netherlands

4 University Medical Center Utrecht, Utrecht, Netherlands

5 Helsinki University Hospital, Helsinki, Finland

6 University of Szeged 1st Dept. of Medicine, Szeged, Hungary

7 San Camillo-Forlanini Hospital, Rome, Italy

8 Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IIS-Princesa), Universidad Autónoma de Madrid (UAM), Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Madrid, Spain

9 Samsung Medical Center, Seoul, Korea, Republic of

10 IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy

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Abstract

Introduction

Side effects, patient preference, and high costs may prompt cessation of anti-TNF therapy in ulcerative colitis (UC) patients in sustained remission. Given the risk of relapse, careful patient selection is essential. This study aimed to assess relapse rates and identify predictors of relapse following anti-TNF cessation in UC patients in remission.

Aims & Methods

A systematic search on cohort studies reporting relapse rates after cessation of anti-TNF therapy in ≥30 UC patients in clinical remission was performed 6 September 2024. Individual patient data was requested. We excluded patients with steroid use, ≤6 months anti-TNF therapy, ≤16 years, previous colectomy (n=4), golimumab as anti-TNF therapy (n=3) or without follow-up. Continuation of treatment with immunomodulators or mesalamine at cessation of anti-TNF was allowed. Relapse was defined as the need to (re)start treatment with steroids, anti-TNF or other advanced therapies, or the need for surgical treatment, as applied by the original author. Pooled relapse rates were computed using a random-effects model. A prediction model was built with a Cox proportional hazards model, performance assessed by iteratively leaving one study out (internal-external cross-validation, IECV). Missing covariate data were multiply imputed 100 times using the MICE algorithm. Variable selection was guided by three criteria: ≤20% missing data, a univariate p-value ≤ 0.2, and input from clinical experts.

Results

In total, 654 patients from 8 studies were included in the individual participant data meta-analysis. At anti-TNF cessation, median age was 40 years (IQR 31-51) with a median anti-TNF treatment of 18 months (IQR 18-36). The majority of patients were treated with infliximab (n = 610, 93%). Only 42 patients (9%) received a second-line anti-TNF therapy. The pooled relapse rate were 24% [95% CI 19-29%, I² = 44%] and 34% [95% CI 29-40%, I²= 39] at 1 and 2 years after cessation, respectively. Upon cessation, 211 patients (33%) continued mesalamine, 239 (39%) thiopurines, and 136 (22%) a combination of both. In our model, thiopurine therapy and older age at cessation were associated with a reduced risk of relapse, whereas immunomodulator refractoriness as an indication for starting anti-TNF therapy was associated with an increased risk. Other factors included in the prediction model were disease extent, type of anti-TNF therapy, history of anti-TNF therapy, fecal calprotectin level and endoscopic activity, leading to a c statistic of 0.55 [95% CI 0.51-0.59] (Table 1).

Table 1: Predictors of relapse in a pooled Cox regression analysis

Variable	Hazard Rate	95% Confidence interval
Age at discontinuation, per 10 years	0.80	0.72 – 0.88
Ulcerative colitis disease extent, Proctitis vs. extensive Left-sided vs. extensive	1.4 1.1	0.92 – 2.1 0.87 – 1.5
Type of anti-TNF therapy, adalimumab vs. infliximab	0.91	0.55 – 1.5
≥1 previous anti-TNF, yes vs. no	1.5	0.95 – 2.3
Indication anti-TNF therapy Immunomodulator refractoriness, yes vs no/unknown	1.5	1.1 – 2.2
Concomitant treatment after anti-TNF therapy, None vs thiopurine Mesalamine vs. thiopurine Combination of mesalamine and thiopurines vs thiopurine	1.8 1.2 1.2	1.1 – 3.0 0.86 – 1.6 0.81 – 1.7
Fecal Calprotectin (µg/g), per 100	1.1	0.95 – 1.3
Endoscopic activity, yes (mild, moderate or severe) vs. no	1.3	0.91 – 2.0

Conclusion

Approximately 1 in 4 patients experience a relapse of UC within 1 year after anti-TNF cessation, increasing to 1 in 3 within 2 years. Continuation of thiopurines is associated with a reduced risk. A prediction model for relapse was developed in this large IPD meta-analysis cohort and may aid in shared decision-making on anti-TNF cessation. However, its limited discriminative ability underscores the need for further refinement, incorporating data on microscopic remission and molecular and immunological markers to better capture deeper disease control.

Event

UEG Week Berlin 2025

Topics

Gut Microbiota IBD Immunology Mechanisms & Personalised Medicine

Submission format

Late-Breaking Abstract

Session

Late-breaking trials in IBD

Citation

United European Gastroenterology Journal 2025; 13 (Supplement 8)

Published

2025

More Like This:

RISK OF RELAPSE AFTER CESSATION OF ANTI-TNF THERAPY IN ULCERATIVE COLITIS IN CORTICOSTEROID-FREE CLINICAL REMISSION: AN INDIVIDUAL PARTICIPANT DATA META-ANALYSIS (IPD-MA) ON 654 PATIENTS FROM 8 STUDIES

Gionata Fiorino

The treatment

Judith Wellens

How to boost your biology? Every day strategies to improve therapies and combinations

Britta Siegmund

INFLAMMAGEING AND RISK OF DIGESTIVE SYSTEM DISEASES: A LARGE COHORT STUDY BASED ON THE UK BIOBANK

Yan Qin

Introduction: The Crohn´s disease journey

Ailsa L Hart

DIGESTIVE ULTRASOUND: A KEY TOOL IN CROHN'S DISEASE MONITORING

Walid boukamza

UEG Presentation

Share via Email Share on Facebook Share on X Share on LinkedIn Share on Bluesky

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The treatment

Judith Wellens 1

Affiliations

1 University Hospitals Leuven, Leuven, Belgium

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Abstract

Event

UEG Week Berlin 2025

Topics

IBD Primary Care

Session

When IBD and IBS experts collaborate for optimal diagnosis and treatment of IBD with IBS-like symptoms

Citation

United European Gastroenterology Journal 2025; 13 (Supplement 8)

Published

2025

More Like This:

RISK OF RELAPSE AFTER CESSATION OF ANTI-TNF THERAPY IN ULCERATIVE COLITIS IN CORTICOSTEROID-FREE CLINICAL REMISSION: AN INDIVIDUAL PARTICIPANT DATA META-ANALYSIS (IPD-MA) ON 654 PATIENTS FROM 8 STUDIES

Gionata Fiorino

The treatment

Judith Wellens

How to boost your biology? Every day strategies to improve therapies and combinations

Britta Siegmund

INFLAMMAGEING AND RISK OF DIGESTIVE SYSTEM DISEASES: A LARGE COHORT STUDY BASED ON THE UK BIOBANK

Yan Qin

Introduction: The Crohn´s disease journey

Ailsa L Hart

DIGESTIVE ULTRASOUND: A KEY TOOL IN CROHN'S DISEASE MONITORING

Walid boukamza

UEG Presentation

Share via Email Share on Facebook Share on X Share on LinkedIn Share on Bluesky

How to boost your biology? Every day strategies to improve therapies and combinations

This content is part of Gutflix. Log in with your myUEG account, or create one free, to watch it.

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How to boost your biology? Every day strategies to improve therapies and combinations

Britta Siegmund 1

Affiliations

1 Charité - Universitätsmedizin Berlin, Berlin, Germany

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Abstract

Event

UEG Week Berlin 2025

Topics

IBD Mechanisms & Personalised Medicine Surgery

Session

How to optimise success in IBD treatment

Citation

United European Gastroenterology Journal 2025; 13 (Supplement 8)

Published

2025

More Like This:

RISK OF RELAPSE AFTER CESSATION OF ANTI-TNF THERAPY IN ULCERATIVE COLITIS IN CORTICOSTEROID-FREE CLINICAL REMISSION: AN INDIVIDUAL PARTICIPANT DATA META-ANALYSIS (IPD-MA) ON 654 PATIENTS FROM 8 STUDIES

Gionata Fiorino

The treatment

Judith Wellens

How to boost your biology? Every day strategies to improve therapies and combinations

Britta Siegmund

INFLAMMAGEING AND RISK OF DIGESTIVE SYSTEM DISEASES: A LARGE COHORT STUDY BASED ON THE UK BIOBANK

Yan Qin

Introduction: The Crohn´s disease journey

Ailsa L Hart

DIGESTIVE ULTRASOUND: A KEY TOOL IN CROHN'S DISEASE MONITORING

Walid boukamza

UEG Presentation

Share via Email Share on Facebook Share on X Share on LinkedIn Share on Bluesky

INFLAMMAGEING AND RISK OF DIGESTIVE SYSTEM DISEASES: A LARGE COHORT STUDY BASED ON THE UK BIOBANK

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INFLAMMAGEING AND RISK OF DIGESTIVE SYSTEM DISEASES: A LARGE COHORT STUDY BASED ON THE UK BIOBANK

Weixiang Guan 1, Yan Qin 2, Yajie Zhang 3, Weihong Sha 3, Hao Chen 1

Affiliations

1 Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou 510080, China, Guangzhou, China|||South China University of Technology, Guangzhou, China

2 The First Affiliated Hospital of Guangzhou Medical University, Guangzhouchi, China

3 Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou 510080, China, Guangzhou, China

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Abstract

Introduction

Chronic low-grade inflammation, known as inflammageing, has been implicated in the pathogenesis of various digestive diseases. However, large-scale systematic evaluations of the association between inflammageing biomarker profiles and digestive system disorders remain scarce. Understanding these associations may have important implications for early detection and intervention strategies.

Aims & Methods

Leveraging the multidimensional data from the UK Biobank, this study aimed to investigate the longitudinal relationships between circulating inflammatory markers and major digestive diseases. A total of 45,475 participants were included, with inflammageing levels calculated as the average of standardized values of four circulating inflammatory markers: TNF, IL1RN, IL18, and IL6.
Digestive disease outcomes were identified from hospital records (HES) and death registries, covering 25 major diagnoses, including gastroesophageal reflux disease (GERD), inflammatory bowel disease (IBD), and non-alcoholic fatty liver disease (NAFLD). Cox proportional hazards models were used to estimate hazard ratios (HRs), adjusting for age, sex, BMI, smoking, and other potential confounders.
In addition, Mendelian randomization (MR) analysis was conducted using GWAS data derived from inflammageing scores to evaluate potential causal effects on digestive outcomes. Mediation and subgroup analyses were performed to explore possible mediating factors.

Results

In the Cox regression analysis, 22 out of 25 digestive outcomes showed significant associations with baseline inflammageing levels (Bonferroni-corrected P < 0.05), with HRs ranging from 1.2 to 2.4.
Mediation analysis identified neutrophil counts and LDL-C as important mediators in these associations, suggesting potential biological pathways linking inflammageing to digestive disease development.

Conclusion

Elevated baseline inflammageing levels were significantly associated with a wide spectrum of digestive system diseases. The findings highlight a potential mechanistic role of systemic inflammation in digestive disease pathogenesis. The use of inflammageing-related biomarkers may aid in early identification of high-risk individuals, offering opportunities for early prevention and targeted interventions.

Event

UEG Week Berlin 2025

Topics

IBD Mechanisms & Personalised Medicine Small Intestine & Nutrition Radiology & Imaging

Submission format

Abstract

Session

IBD: What about the environment?

Citation

United European Gastroenterology Journal 2025; 13 (Supplement 8)

Published

2025

More Like This:

RISK OF RELAPSE AFTER CESSATION OF ANTI-TNF THERAPY IN ULCERATIVE COLITIS IN CORTICOSTEROID-FREE CLINICAL REMISSION: AN INDIVIDUAL PARTICIPANT DATA META-ANALYSIS (IPD-MA) ON 654 PATIENTS FROM 8 STUDIES

Gionata Fiorino

The treatment

Judith Wellens

How to boost your biology? Every day strategies to improve therapies and combinations

Britta Siegmund

INFLAMMAGEING AND RISK OF DIGESTIVE SYSTEM DISEASES: A LARGE COHORT STUDY BASED ON THE UK BIOBANK

Yan Qin

Introduction: The Crohn´s disease journey

Ailsa L Hart

DIGESTIVE ULTRASOUND: A KEY TOOL IN CROHN'S DISEASE MONITORING

Walid boukamza

UEG Presentation

Share via Email Share on Facebook Share on X Share on LinkedIn Share on Bluesky

Introduction: The Crohn´s disease journey

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Introduction: The Crohn´s disease journey

Ailsa L Hart 1

Affiliations

1 St Mark’s Hospital and Academic Institute, Harrow, United Kingdom

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Abstract

Event

UEG Postgraduate Teaching Programme Berlin 2025

Topics

IBD Surgery

Session

The Crohn´s disease journey

Citation

United European Gastroenterology Journal 2025; 13 (Supplement 8)

Published

2025

More Like This:

RISK OF RELAPSE AFTER CESSATION OF ANTI-TNF THERAPY IN ULCERATIVE COLITIS IN CORTICOSTEROID-FREE CLINICAL REMISSION: AN INDIVIDUAL PARTICIPANT DATA META-ANALYSIS (IPD-MA) ON 654 PATIENTS FROM 8 STUDIES

Gionata Fiorino

The treatment

Judith Wellens

How to boost your biology? Every day strategies to improve therapies and combinations

Britta Siegmund

INFLAMMAGEING AND RISK OF DIGESTIVE SYSTEM DISEASES: A LARGE COHORT STUDY BASED ON THE UK BIOBANK

Yan Qin

Introduction: The Crohn´s disease journey

Ailsa L Hart

DIGESTIVE ULTRASOUND: A KEY TOOL IN CROHN'S DISEASE MONITORING

Walid boukamza

UEG Poster

Standard Poster

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DIGESTIVE ULTRASOUND: A KEY TOOL IN CROHN'S DISEASE MONITORING

Sarra EL FASSI 1, Soufian AMAZGUIOU 1, Rabii Ajana 1, Walid boukamza 1, Karima Sammoud 1, Faiza Charif 1, Adil Najdi 1, Aicha Akjay 1, Hassan Ouaya 1, Houda Meyiz 1, mellouki ihssane 1

Affiliations

1 CHU Mohammed VI, Tangier, Morocco

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Abstract

Introduction

Intestinal ultrasound is a noninvasive and inexpensive tool to assess disease activity in patients with inflammatory bowel disease, such as Crohn's and ulcerative colitis by monitoring the disease activity in real time.

Aims & Methods

Intestinal ultrasound is a non-invasive, cost-effective imaging tool for routine clinical evaluations. This study examines its role in monitoring Crohn’s disease, comparing it with CT Enterography.
This is a prospective, descriptive, comparative study including patients with crohn's disease aged over 16, between March 2023 and March 2024. Every patient had a colonoscopy, enteroscan, and digestive ultrasonography; the delay between each test was limited to one month by the same operator. Patients with ileal or recto-colic resections or pregnant women were not included. We develope a form to collect clinical, therapeutic, and epidemiological informations as well as the outcomes of CT, colonoscopy, and ultrasounds. Between ultrasound, CT scan and colonoscopy, we asked our patients to choose the most widely accepted para-clinical test. Ultrasonography's sensitivity (Se) and specificity (Sp) were determined, and data from enteroscanner and ultrasound were analyzed, with a focus on the wall's thickness, vascularization, damage extent, and peridigestive environment. The statistical study was carried out using SPSS 21.0 software. Quantitative variables were expressed as medians and qualitative variables as numbers and percentages. The McNemar test and the Wilcoxon test for associated samples were applied. The significance level was set at 0.05.

Results

Forty-nine patients were included, with a male-to-female ratio of 0.53 and a median age of 32 years. US detected digestive thickening in 81.6% of cases, mainly in the terminal ileum. CT Enterography detected thickening in the proximal small bowel and rectum in 2.2% of cases, which US missed. US sensitivity was 84.4%, with specificity of 50%. No significant difference was found between US and CT for thickening detection. Mesenteric infiltration detected by US was similar to CT (Se = 86.5%, Sp = 100%). For adenopathy, Se was 75% (Sp = 97%). US showed a 60% sensitivity for detecting complications, with a significant difference compared to CT (p = 0.002). There was no correlation between thickening on US and ulcers on endoscopy.

Conclusion

Despite limitations in examining the proximal intestine and rectum, intestinal ultrasonography is a sensitive, accessible method for monitoring Crohn’s disease and detecting complications.

Conference

UEG Week Berlin 2025

Topics

IBD

Submission format

Abstract

Session

IBD (Posters)

Citation

United European Gastroenterology Journal 2025; 13 (Supplement 8)

Published

2025

More Like This:

RISK OF RELAPSE AFTER CESSATION OF ANTI-TNF THERAPY IN ULCERATIVE COLITIS IN CORTICOSTEROID-FREE CLINICAL REMISSION: AN INDIVIDUAL PARTICIPANT DATA META-ANALYSIS (IPD-MA) ON 654 PATIENTS FROM 8 STUDIES

Gionata Fiorino

The treatment

Judith Wellens

How to boost your biology? Every day strategies to improve therapies and combinations

Britta Siegmund

INFLAMMAGEING AND RISK OF DIGESTIVE SYSTEM DISEASES: A LARGE COHORT STUDY BASED ON THE UK BIOBANK

Yan Qin

Introduction: The Crohn´s disease journey

Ailsa L Hart

DIGESTIVE ULTRASOUND: A KEY TOOL IN CROHN'S DISEASE MONITORING

Walid boukamza

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