P0185 Prevalence of IBS-like symptoms in Ulcerative Colitis patients in clinical remission

Abstract Background Irritable bowel syndrome (IBS) is a common gastrointestinal disorder with a higher prevalence in patients with inflammatory bowel disease (IBD) compared to the general population. Ulcerative colitis (UC) patients frequently report symptoms such as abdominal discomfort, bloating, altered bowel habits, and worsening symptoms due to foods or stress, even during clinical remission. This study examines the prevalence of IBS-like symptoms in UC patients at an IBD clinic in a London teaching hospital. Methods A survey among 100 UC patients included those with active disease (flare) and in remission. Remission status was defined by: (1) faecal calprotectin levels ≤250µg/g in the last year, (2) C-reactive protein (CRP) within the normal range in the past six months, and (3) a Mayo score of 0 on a flexible sigmoidoscopy/colonoscopy within 6 months. The IBS information questionnaire was based on WHO criteria1 and included 16 questions. Data collected included disease location, year of diagnosis, gender, and current treatment. Results Among the 100 patients, 34% had active disease and 66% were in remission during time of survey completion and 91% on active drug management. Total symptom scores differed significantly between active and remission groups (p=0.0066), with higher scores in active disease. However, 94% of patients in remission reported 1< symptom and the mean total score was 11.32 (SD ~6.08) indicating persistent symptoms. There is a female preponderance in symptoms scores than males in both active and remission states. In active disease, females had a mean score of 16.67 (SD: 5.91) vs males at 11.53 (SD: 5.66); in remission, females scored 11.77 (SD: 5.96) vs males at 9.59 (SD: 5.56). A statistically significant gender difference was found in active disease (p=0.0144) but not in remission (p=0.129). Table 1 shows symptoms reported in remission. Bloating correlated with constipation (r=0.32, p=0.008), potentially indicating proximal constipation in UC remission. Additionally, loose stools were strongly correlated with bowel urgency (r=0.73, p=<0.0001), suggesting a symptom cluster. Among remission patients, proctitis showed the highest scores, while pancolitis scored the lowest. Disease location was weakly negatively correlated with symptom scores (r=-0.19, p=0.76), as was time since UC diagnosis (r=-0.13, p=0.305). Conclusion This study shows that IBS-like symptoms persist in UC patients during remission, with 94% reporting 1< symptom despite active drug management. Symptom clusters such as loose stools and bowel urgency and gender differences, emphasise the need for tailored, symptom-focused care. Comprehensive strategies are essential to address residual symptoms and improve quality of life for UC patients, even in remission. References 1.World Gastroenterology Organisation. Test for Diagnosing IBS. Published 2009. Available at: https://www.worldgastroenterology.org/UserFiles/file/wdhd-2009-test-for-diagnosing-ibs.pdf