A0257 - Comparison of Disorders of Gut-Brain Interaction and Gastrointestinal Motility Between Patients With and Without IBD

Sunday, October 23, 2022

5:00 PM – 7:00 PM ET

Location: Crown Ballroom

Presenting Author(s)

Yuhan Fu, DO

MetroHealth Medical Center/Case Western Reserve University
Cleveland, OH

Yuhan Fu, DO, Michael Kurin, MD, Ronnie Fass, MD, Gengqing Song, MD
MetroHealth Medical Center/Case Western Reserve University, Cleveland, OH

Introduction: Disordered brain-gut axis has been implicated in the pathogenesis of inflammatory bowel disease (IBD) and functional gastrointestinal disorders. It is increasingly recognized that patients can have overlapping IBD and irritable bowel syndrome (IBS). However, the prevalence of this phenomenon is not fully elucidated. The aim of the study was to determine the prevalence of coexisting gastrointestinal motility disorders and disorders of gut brain interaction (DGBI) in patients with Crohn’s disease (CD) and ulcerative colitis (UC).

Methods: A population-based study was performed using IBM Explorys (1999-2022), a large pooled de-identified database with patient information from more than 300 hospitals across the US. CD and UC cohorts consisted of patients with a diagnosis of CD and UC, respectively. The control group consisted of patients without a diagnosis of IBD. We collected information about gastroparesis, IBS, functional dyspepsia (FD), gastroesophageal reflux disease (GERD), esophageal dysmotility and GI symptoms in all three cohorts. Categorial data was presented as number of subjects and percentages. Odds ratios (OR) with 95% confidence interval were used to compare between the cohorts.

Results: CD, UC and the non-IBD control cohorts consisted of 209,660, 251,570 and 79,390,670 patients respectively (Table 1). There was a higher prevalence of IBS and GERD in both CD and UC patients compared with non-IBD patients (IBS in CD, UC and control:13.2 vs 11.5 vs 1.24%; GERD in CD, UC and control: 33.2% vs 32.4 vs 8.8% respectively). Both CD and UC were more likely to have other co-existing DGBI and motility disorders compared with non-IBD patients, including gastroparesis (GP) and esophageal dysmotility (ED) (GP:CD vs control: OR [2.53-2.81], UC vs control: OR [2.28-2.57]; ED: CD vs control: OR [4.88-5.32], UC vs control: OR [5.39-5.90]). FD was more likely to occur in patients with CD than the control (OR 3.25-3.73), while UC has less risk of FD than the control (OR 0-0.04). Both patients with CD and UC were more likely to complain about various GI symptoms than the control, including nausea, vomiting, early satiety, epigastric pain, dysphagia, heartburn, diarrhea, and constipation (p< 0.0001).

Discussion: IBD is associated with an increased prevalence of concomitant DGBI and motility disorders than non-IBD. IBD patients experience GI symptoms more often than non-IBD patients.

	CD (N=251,570)		UC (N=209,660)		Control (n=79,390,670)		CD vs control		UC vs control
	CD (N=251,570)		UC (N=209,660)		Control (n=79,390,670)		OR	P	OR	P
IBS	33330	13.2%	24120	11.50%	984250	1.24%	12.02-12.31	< 0.0001	10.22-10.50	< 0.0001
GERD	83530	33.2%	67940	32.40%	7004850	8.82%	5.09-5.18	< 0.0001	4.91-5.00	< 0.0001
Gastroparesis	1410	0.6%	1070	0.51%	167720	0.21%	2.53-2.81	< 0.0001	2.28-2.57	< 0.0001
FD	790	0.3%	0	0.00%	71770	0.09%	3.25-3.73	< 0.0001	0.00-0.04	< 0.0001
Esophageal dysmotility	2050	0.8%	1890	0.90%	127820	0.16%	4.88-5.32	< 0.0001	5.39-5.90	< 0.0001

Nausea	73350	29.2%	51380	24.51%	5036360	6.86%	6.02-6.13	< 0.0001	4.74-4.84	< 0.0001
Vomiting	59580	23.7%	42850	20.44%	4996190	6.81%	4.58-4.66	< 0.0001	3.78-3.87	< 0.0001
Early satiety	1500	0.6%	1180	0.56%	69760	0.10%	6.48-7.18	< 0.0001	6.07-6.82	< 0.0001
Epigastric pain	30350	12.1%	22810	10.88%	1894830	2.58%	5.54-5.68	< 0.0001	4.92-5.06	< 0.0001
Dysphagia	20120	8.0%	18390	8.77%	1664800	2.27%	4.00-4.12	< 0.0001	4.42-4.56	< 0.0001
Heartburn	7490	3.0%	6810	3.25%	506700	0.69%	4.67-4.89	< 0.0001	5.10-5.36	< 0.0001
Diarrhea	86060	34.2%	73500	35.06%	3731830	5.08%	10.45-10.63	< 0.0001	10.85-11.04	< 0.0001
Constipation	43000	17.1%	31800	15.17%	3585490	4.89%	4.31-4.40	< 0.0001	3.74-3.83	< 0.0001

Table: Table 1 Comparison of Disorders of Gut-Brain Interaction and Gastrointestinal Motility Between Patients with and without IBD

Disclosures:

Yuhan Fu indicated no relevant financial relationships.

Michael Kurin indicated no relevant financial relationships.

Ronnie Fass indicated no relevant financial relationships.

Gengqing Song indicated no relevant financial relationships.

Yuhan Fu, DO, Michael Kurin, MD, Ronnie Fass, MD, Gengqing Song, MD. A0257 - Comparison of Disorders of Gut-Brain Interaction and Gastrointestinal Motility Between Patients With and Without IBD, ACG 2022 Annual Scientific Meeting Abstracts. Charlotte, NC: American College of Gastroenterology.