title: Characterization of IBS-like symptoms in patients with ulcerative colitis in clinical remission.
abstract: BACKGROUND
  Gastrointestinal symptoms compatible with Irritable Bowel Syndrome (IBS) are common in patients with inflammatory bowel disease. It has been suggested that these symptoms are a reflection of occult inflammation rather than coexisting IBS. The aim of this study was to characterize IBS-like symptoms in patients with Ulcerative Colitis (UC) in clinical remission by assessing inflammatory markers, psychological symptoms, and quality of life.
  
  
  METHODS
  Ninety-four patients with new onset of UC were followed prospectively during 3 years with yearly follow-up visits. The patients completed self-administrated questionnaires. Fecal calprotectin was used as an inflammatory biomarker. Remission was defined as a total Mayo-score ≤2 and an endoscopic subscore ≤1, with no relapse during the 3-month period prior to visit.
  
  
  RESULTS
  The prevalence of patients that fulfilled Rome II criteria for IBS among UC patients in remission was 11% at visit 1, 23% at visit 2, and 17% at visit 3. When comparing UC patients in remission with and without IBS-like symptom, patients with IBS-like symptoms had more severe gastrointestinal symptoms, tendencies toward more severe psychological symptoms and reduced levels of quality of life, but the calprotectin levels did not differ between the two groups.
  
  
  CONCLUSIONS
  IBS-like symptoms are common in patients with UC in clinical remission and these fluctuate over time. The symptoms are associated with poor psychological well-being and reduced quality of life, and do not seem to be a reflection of low-grade inflammatory activity.
authors.affiliation: Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. borje.jonefjall@vgregion.se
authors.forename: B
authors.initials: B
authors.lastname: Jonefjäll
authors.forename: H
authors.initials: H
authors.lastname: Strid
authors.forename: L
authors.initials: L
authors.lastname: Ohman
authors.forename: J
authors.initials: J
authors.lastname: Svedlund
authors.forename: A
authors.initials: A
authors.lastname: Bergstedt
authors.forename: M
authors.initials: M
authors.lastname: Simren
mesh_terms: D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000032:analysis; D003093:Colitis, Ulcerative / Q000150:complications* / Q000473:pathology / Q000523:psychology; D005243:Feces / Q000737:chemistry; D005260:Female; D006801:Humans; D007249:Inflammation / Q000453:epidemiology* / Q000378:metabolism; D043183:Irritable Bowel Syndrome / Q000453:epidemiology* / Q000523:psychology; D039841:Leukocyte L1 Antigen Complex / Q000032:analysis; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011788:Quality of Life; D012074:Remission Induction; D011795:Surveys and Questionnaires; D055815:Young Adult
chemical_list: D015415:Biomarkers; D039841:Leukocyte L1 Antigen Complex
keywords: Fecal Calprotectin; Functional GI symptoms; IBD; IBS; Ulcerative Colitis