P136 Multidimensional assessment of visceral hypervigilance in patients with IBD

Abstract

Abstract Background Persons with inflammatory bowel diseases (IBD) can suffer from irritable bowel syndrome (IBS-like) symptoms in the absence of inflammation. Also, the prevalence of anxiety symptoms and disorders is increased in IBD. Both IBS-like and anxiety symptoms impair quality of life and are challenging to treat as well as poorly understood in IBD. Visceral hypervigilance (VH) as a specific form of anxiety and a common feature of disorders of gut-brain interaction may be a relevant symptom in IBD and could relate to IBS-like symptoms. This study aimed at investigating clinical, psychological and biological factors associated with VH in persons with IBD. Methods We used the visceral sensitivity index (VSI) to investigate VH in 308 patients with different states of IBD disease activity (as determined by Harvey Bradshaw Index or partial Mayo Score). We further assessed demographic (age, sex), clinical (disease duration, CRP levels) and psychological (anxiety and depression, HADS) characteristics. Genetic and metabolic parameters related to serotonin metabolism were analyzed in subsamples with active disease (single nucleotide polymorphisms in genes related to serotonin signaling (n=83) and serum tryptophan metabolites (n=70)). We used multiple regression analyses to examine which factors could predict patients’ VH levels and to explore genetic and metabolic predictors of VH. Results The strongest predictors for VH were anxiety, depression and disease activity (all p < .001, Fig.1, left). Explorative analyses revealed polymorphisms in the HTR3A (p = .028) and SERT gene (p = .030) to predict VH (Fig.1, middle). While clinical disease activity was related to VH, there was no association between VH and inflammatory biomarkers or tryptophan metabolites (Fig.1, left and right). Conclusion VH as a specific type of anxiety strongly relates to psychopathology in persons with IBD. Anxiety was found to be the strongest predictor of VH, contributing to a greater extent to VH than disease activity. Possible genetic predispositions of VH should be investigated in larger studies. Screening patients for VH could help to detect disturbances in gut-brain-interactions and improve individualized treatment.