Irritable Bowel Syndrome

肠易激综合症

• 批准号: 9188422
• 负责人: Xiaomei Sophia Cong
• 金额: $ 1.98万
• 依托单位: UNIVERSITY OF CONNECTICUT STORRS
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-07-22 至 2021-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9188422
• 关键词: Abdomen; Adult; Affect; Area; Behavior; Brain; Caring; Chronic; Consultations; Control Groups; Data; Diagnostic tests; Direct Costs; Disease; Distal; Distress; Doctor of Philosophy; Elderly; Electronics; Enrollment; Family; Future; General Population; Genes; Genetic; Genetic Polymorphism; Genomics; Goals; Health behavior outcomes; Individual; Informal Social Control; Intervention; Irritable Bowel Syndrome; Journals; Knowledge; Learning; Living Costs; Measures; Metagenomics; Methods; Monitor; Neuraxis; Outcome; Outpatients; Pain; Pain Disorder; Participant; Patients; Perception; Peripheral; Physical activity; Pilot Projects; Positioning Attribute; Prevalence; Process; Productivity; Quality of life; Randomized; Recurrence; Reporting; Self Efficacy; Self Management; Self-Examination; Sensory; Severities; Single Nucleotide Polymorphism; Symptoms; Testing; Visceral; Visceral pain; Visit; Woman; Work; abstracting; base; central pain; contextual factors; coping; design; gut microbiome; health care service; health care service utilization; improved; innovation; insight; microbiome; neurophysiology; peripheral pain; post intervention; skills; stress reactivity; young adult; young man; young woman

Project Abstract   Intense, recurrent abdominal (visceral) pain is a predominant symptom of irritable bowel syndrome (IBS), a functional gut disorder that typically manifests in the early adult years1. IBS is common with prevalence reaching over 20% in some regions of the world, and affects more women than men2,3. While women report more severe IBS-related pain, both younger men and women report more severe pain compared to older adult cohorts4,5. Direct costs of care and lost productivity in the U.S. exceed $21 billion annually, and individuals with IBS utilize more healthcare services than the general population, including outpatient visits, diagnostic testing and over-the-counter and prescription medications6. Individuals with IBS report that pain is the most distressing symptom and has the greatest impact on quality of life1, however, current approaches to improve self- management of IBS-related pain do not target individual, context-specific factors of pain. Therefore, individuals with IBS-related pain often endure a long and frustrating course of learning how to manage pain on their own accord. The proposed pilot project was developed based on this common situation and will provide feasibility data about the influence of providing a personalized pain SM intervention to individuals with IBS-related pain. IBS-related pain is associated with sensitization of the central nervous system, and approximately half of all patients with IBS have visceral hypersensitivity7-9. These alterations in pain processing escalate pain perception, and can increase vulnerability to other comorbid pain disorders which individuals with IBS frequently suffer7,8. Pain sensitization is influenced by pain-sensitivity genes and, specific to IBS-related pain, the gut microbiome10-13. Therefore, as contextual factors of pain associated with IBS, we will measure peripheral and central sensitivity, single-nucleotide polymorphisms (SNPs) of candidate pain-sensitivity genes and the gut microbiome. The SM intervention was designed to provide factual information about IBS pain, triggers of pain and pain SM skills. The experimental group will receive one-on-one consultation tailored around the individual's assessment results of peripheral and central pain sensitivity as measured by quantitative sensory testing (QST) and targeted toward increasing pain self-efficacy and self-regulation skills and abilities.   The proposed pilot project will provide foundational information about the contextual factors of IBS pain (pain catastrophizing, perceived stress, reactivity pain sensitivity, genetic and microbiome) on pain SM process and outcomes. In addition, we will gain insight on the potential impact of the personalized IBS-pain SM approach on pain SM behaviors and health outcomes. The knowledge gained from this pilot study will position the PPI and her team for future work in the area of precision pain SM, using innovative methods to improve quality of life and costs of care for individuals and families with IBS pain.

项目摘要   剧烈、反复出现的腹部（内脏）疼痛是肠易激综合征 (IBS) 的主要症状， 功能性肠道疾病通常出现在成年早期1。 IBS 很常见，患病率也很高 在世界某些地区，这一比例超过 20%，并且影响的女性多于男性2,3。虽然女性报告 与肠易激综合症相关的疼痛更严重，与老年人相比，年轻男性和女性都报告了更严重的疼痛 队列4,5。在美国，每年的直接护理成本和生产力损失超过 210 亿美元，患有此类疾病的个人 IBS 使用比一般人群更多的医疗服务，包括门诊、诊断测试 以及非处方药和处方药6。患有肠易激综合症的人报告说疼痛是最令人痛苦的 症状并对生活质量影响最大1，然而，目前改善自我的方法 IBS 相关疼痛的治疗并不针对个体、特定情况的疼痛因素。因此，个人 患有肠易激综合症相关疼痛的人通常要经历漫长而令人沮丧的过程，学习如何自行控制疼痛 符合。拟议的试点项目是根据这种常见情况制定的，并将提供可行性 有关为 IBS 相关疼痛患者提供个性化疼痛 SM 干预的影响的数据。 IBS 相关疼痛与中枢神经系统的敏感性有关，大约一半的疼痛与中枢神经系统的敏感性有关。 IBS 患者有内脏过敏7-9。这些疼痛处理的改变会加剧疼痛 知觉，并且可能增加患有肠易激综合症（IBS）患者的其他共病疼痛疾病的脆弱性 经常受苦7,8。疼痛敏感性受到疼痛敏感性基因的影响，并且特定于 IBS 相关疼痛， 肠道微生物组10-13。因此，作为与 IBS 相关的疼痛的背景因素，我们将测量 外周和中枢敏感性，候选疼痛敏感基因的单核苷酸多态性（SNP） 和肠道微生物组。 SM 干预旨在提供有关 IBS 疼痛的事实信息， 痛苦的触发点和痛苦SM技能。实验组将接受量身定制的一对一咨询 围绕个人的外周和中枢疼痛敏感性评估结果，通过测量 定量感觉测试（QST），旨在提高疼痛自我效能和自我调节技能 和能力。   拟议的试点项目将提供有关 IBS 疼痛背景因素的基础信息（疼痛 灾难化、感知压力、反应性疼痛敏感性、遗传和微生物组）对疼痛 SM 过程和 结果。此外，我们还将深入了解个性化 IBS 疼痛 SM 方法的潜在影响 关于疼痛 SM 行为和健康结果。从这项试点研究中获得的知识将定位 PPI 和她的团队未来在精准疼痛 SM 领域的工作，使用创新方法来提高治疗质量 患有 IBS 疼痛的个人和家庭的生命和护理费用。