Nearly 70% of patients with inflammatory bowel disease may experience chronic pain, yet 29% of them report that their pain is frequently unaddressed during clinical visits. 

In a new study, published in BMJ Open Gastroenterology, researchers examined differences in pain communication priorities between clinicians and patients with inflammatory bowel disease (IBD), identifying areas for improvement in pain management. Interviews with 25 IBD clinicians—including gastroenterologists, colorectal surgeons, specialist nurses, and psychologists—alongside an analysis of patient interviews, highlighted reported discrepancies in pain assessment and management. Clinicians reported focusing primarily on disease activity in Crohn’s disease but often did not address pain directly in ulcerative colitis, presuming that patients managed pain independently unless it indicated inflammation.

However, patients reported inconsistent inquiry into pain during consultations. In one UK survey, 29% of patients noted that their pain was not addressed. Challenges within the health care system, such as time constraints and limited pain management resources, were cited as factors, with power dynamics that may affect patients' comfort in fully discussing pain. For instance, some clinicians attributed pain without inflammatory findings to irritable bowel syndrome, which some patients reported as affecting their trust in clinical care.

Patients reported feeling standard pain assessments, such as numeric scales, inadequately capture their experience.

The researchers suggested structured pain assessment tools to facilitate more effective clinician-patient dialogue, helping patients communicate their pain experiences. Clinicians could benefit from prioritizing pain discussions and considering individual pain experiences beyond inflammatory markers to enhance IBD management.

Full disclosures can be found in the published study.