UEG Week 2021 Moderated Posters

Introduction: Abdominal pain is a cardinal symptom of Crohn's disease.Patients often use opiates and cannabis to assuage pain when standard and biologic medication does not produce adequate relief.Psychological stress is known to accentuate the individual's perception of pain.We found that a program of cognitive behavioral and mindfulness-based stress reduction (COBMINDEX) diminishes psychological stress in patients with Crohn's disease. 1 It was therefore of interest to perform an ad hoc analysis to examine whether COBMINDEX could reduce pain in these patients.Aims & Methods: We performed a double-blind trial of COBMINDEX in mild/moderately active Crohn's disease patients who were randomized to COBMINDEX or waitlist controls.Patients were assessed at study entry (time T1) and again at 3 months (T2).At T1 and T2 a clinician completed the Harvey-Bradshaw Index (HBI) and patients filled in the Short Inflammatory Bowel Disease Questionnaire (SIBDQ), MOS 12-Item Short Form Survey Instrument Physical Health (SF-12 PH), and EuroQual 5-Dimensional Questionnaire (EQ-5D-3L).COBMINDEX was taught by specially trained social workers using a one-on-one internet platform between T1 and T2; daily self-practice by the patients was required.Waitlist patients remained on follow-up only.Pain frequency and severity at T1 and T2 were compared between COBMINDEX and waitlist patients.For the analysis the range of responses to the pain questions in HBI (abdominal pain the previous day, 4 responses), SIBDQ (abdominal pain in last 4 weeks, 7 responses) and SF-12 PH (pain in last 2 weeks, 5 responses) were re-coded into 4 responses: none, mild, moderate, severe pain.The pain question in EQ-5D-3L has 3 responses.Statistics: Pearson chi square test, logistic regression controlling for age and gender with pain decrease as the dependent variable.Results: COBMINDEX (n=60) and waitlist (n=66) patients' characteristics were: mean age 34.4y vs 33.1y, biologics 45% vs 40%, immunomodulators 20% vs 15%, respectively.For both groups: women 63%, HBI range 5-7 in 47%, HBI range 8-16 in 53%, opiate use 0. COBMINDEX patients exhibited reduced pain frequency and intensity at T2 vs waitlist by HBI and SIBDQ scales.Pain frequencies (%) in the order as none, mild, moderate, severe were as follows.By HBI, COBMINDEX T1: 8, 23, 57, 12; T2