Features of orofacial and somatic pain manifestations in patients with Crohn’s disease and ulcerative colitis

Yunusova RD, Usmanova IN, Lakman IA, et al. . Features of orofacial and somatic pain manifestations in patients with Crohn’s disease and ulcerative colitis. Russian Journal of Pain. 2025;23(1):10‑15. (In Russ.)
https://doi.org/10.17116/pain20252301110

Подписка 2025 Российский журнал боли (Russian Journal of Pain)

Использование инфографики авторами научных работ

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OBJECTIVE

To analyze intensity, time and pathophysiological type of somatic, orofacial and neuropathic pain symptoms in patients with Crohn’s disease (CD) and ulcerative colitis (UC).

MATERIAL AND METHODS

An observational prospective study included 70 patients with CD and UC in remission. We analyzed status of oral mucosa and vermilion border. Somatic, orofacial and neuropathic pain was assessed using visual analogue scale (VAS) and Douleur Neuropathique 4 (DN4) questionnaire. To estimate the symptoms of gastric and intestinal dyspepsia, we used a validated 7x7 questionnaire.

RESULTS

Severity of somatic abdominal pain was significantly higher patients with CD (p<0.05). On the background of extraintestinal manifestations of inflammatory bowel diseases, intensity of nociceptive diffuse pain in the abdomen with unclear localization and pain-like distension in the stomach after eating was significantly higher in patients with CD (p<0.1). Incidence of neuropathic pain was similar in patients with CD and UC (p=0.037). Scores of orofacial pain following lesions vermilion border and oral mucosa were higher in patients with CD during intake of irritating food and personal hygiene (p<0.05). Mean intensity of orofacial pain corresponds to moderate pain regardless of manifestations of inflammatory bowel diseases (p=0.171). Neuropathic component of pain in these patients was diagnosed in 24.29% of cases.

CONCLUSION

Somatic, orofacial and visceral pain occurs in all patients with Crohn’s disease and ulcerative colitis. Signs of neuropathic pain are observed in 24.29% of cases. These data may be crucial for effective therapeutic approach to these patients.

Keywords:

oral mucosa

vermilion border

VAS

DN4 questionnaire

7×7 questionnaire

Crohn’s disease

ulcerative colitis

Authors:

Yunusova R.D.

Bashkir State Medical University

ORCID: 0000-0003-4556-0864

Usmanova I.N.

Bashkir State Medical University

ORCID: 0000-0002-1781-0291

Lakman I.A.

Bashkir State Medical University;
Ufa University of Science and Technology

ORCID: 0000-0001-9876-9202

Akopyan A.P.

Bashkir State Medical University

SPIN RSCI: 9848-8662
ORCID: 0000-0001-8436-5610

Ishmukhametova A.N.

Bashkir State Medical University

ORCID: 0000-0003-0892-0058

Vasil’ev Yu.L.

First Moscow State Medical University. I.M. Sechenov of the Ministry of Health of Russia (Sechenov University)

Scopus AuthorID: 57194755259
ORCID: 0000-0003-3541-6068

Rabinovich S.A.

Russian University of Medicine

ORCID: 0000-0003-2756-1468

Gaisina E.A.

Kuvatov Republican Clinical Hospital

Received:

29.07.2024

Accepted:

09.10.2024

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References:

Wils P, Caron B, D’Amico F, Danese S, Peyrin-Biroulet L. Abdominal Pain in Inflammatory Bowel Diseases: A Clinical Challenge. J Clin Med. 2022; 11(15):4269. https://doi.org/10.3390/jcm11154269
Drewes AM, Olesen AE, Farmer AD, Szigethy E, Rebours V, Olesen SS. Gastrointestinal pain. Nat Rev Dis Primers. 2020;6(1):1. https://doi.org/10.1038/s41572-019-0135-7
Finnerup NB, Kuner R, Jensen TS. Neuropathic Pain: From Mechanisms to Treatment. Physiol Rev. 2021;101(1):259-301. https://doi.org/10.1152/physrev.00045.2019
Sinopoulou V, Gordon M, Akobeng AK, Gasparetto M, Sammaan M, Vasiliou J, Dovey TM. Interventions for the management of abdominal pain in Crohn’s disease and inflammatory bowel disease. Cochrane Database Syst Rev. 2021;11(11):CD013531. https://doi.org/10.1002/14651858.CD013531.pub2
Cohen SP, Vase L, Hooten WM. Chronic pain: an update on burden, best practices, and new advances. Lancet. 2021;397(10289):2082-2097. https://doi.org/10.1016/S0140-6736(21)00393-7
Fitzcharles MA, Cohen SP, Clauw DJ, Littlejohn G, Usui C, Häuser W. Nociplastic pain: towards an understanding of prevalent pain conditions. Lancet. 2021;397(10289):2098-2110. https://doi.org/10.1016/S0140-6736(21)00392-5
Coates MD, Clarke K, Williams E, Jeganathan N, Yadav S, Giampetro D, Gordin V, Smith S, Vrana K, Bobb A, Gazzio TT, Tressler H, Dalessio S. Abdominal Pain in Inflammatory Bowel Disease: An Evidence-Based, Multidisciplinary Review. Crohn’s & Colitis 360. 2023;5(4):otad055. https://doi.org/10.1093/crocol/otad055
Fairbrass KM, Costantino SJ, Gracie DJ, Ford AC. Prevalence of irritable bowel syndrome-type symptoms in patients with inflammatory bowel disease in remission: a systematic review and meta-analysis. Lancet Gastroenterol Hepatol. 2020;5(12):1053-1062. https://doi.org/10.1016/S2468-1253(20)30300-9
Knowles SR, Graff LA, Wilding H, Hewitt C, Keefer L, Mikocka-Walus A. Quality of Life in Inflammatory Bowel Disease: A Systematic Review and Meta-analyses — Part I. Inflamm Bowel Dis. 2018;24(4):742-751. https://doi.org/10.1093/ibd/izx100
Arendt-Nielsen L, Morlion B, Perrot S, Dahan A, Dickenson A, Kress HG, Wells C, Bouhassira D, Drewes AM. Assessment and manifestation of central sensitisation across different chronic pain conditions. Eur J Pain. 2018; 22(2):216-241. https://doi.org/10.1002/ejp.1140
International Classification of Orofacial Pain, 1st edition (ICOP). Adapted Russian-language version. Almanac of Clinical Medicine. 2022;50 (Suppl):1-82. https://doi.org/10.18786/2072-0505-2022-50-005
Orliaguet M, Misery L. Neuropathic and Psychogenic Components of Burning Mouth Syndrome: A Systematic Review. Biomolecules. 2021;11(8):1237. https://doi.org/10.3390/biom11081237
Ivashkin VT, Sheptulin AA, Poluektova EA, Reikhart DV, Belostotsky AV, Drozdova AA, Arnautov VS. Potential of 7×7 (7 symptoms per 7 days) questionnaire in assessment of symptom dynamics of functional dyspepsia and irritable bowel syndrome. Russian Journal of Gastroenterology, Hepatology, and Coloproctology. 2016;26(3):24-33. (In Russ.). https://doi.org/10.22416/1382-4376-2016-26-3-24-33
Hardy PY, Fikri J, Libbrecht D, Louis E, Joris J. Pain Characteristics in Patients with Inflammatory Bowel Disease: A Monocentric Cross-Sectional Study. J Crohns Colitis. 2022;16(9):1363-1371. https://doi.org/10.1093/ecco-jcc/jjac051
Klein B, Thoppay JR, De Rossi SS, Ciarrocca K. Burning Mouth Syndrome. Dermatol Clin. 2020;38(4):477-483. https://doi.org/10.1016/j.det.2020.05.008
Khozeimeh F, Shakerin H, Daghaghzadeh H, Najarzadegan F, Golestannejad Z, Adibi P. Oral manifestations in inflammatory bowel disease: A cross-sectional study in Isfahan. Dent Res J. 2021;18:4. PMID: 34084291.
Melis M, Mastinu M, Sollai G, Paduano D, Chicco F, Magrì S, Usai P, Crnjar R, Tepper BJ, Barbarossa IT. Taste Changes in Patients with Inflammatory Bowel Disease: Associations with PROP Phenotypes and polymorphisms in the salivary protein, Gustin and CD36 Receptor Genes. Nutrients. 2020 Feb 04;12(2):409. PMID: 32033224; PMCID: PMC7071215. https://doi.org/10.3390/nu12020409
Goldinova A, Tan CX, Bouma G, Duijvestein M, Brand HS, de Boer NK. Oral health and salivary function in ulcerative colitis patients. United European Gastroenterol J. 2020;8(9):1067-1075. https://doi.org/10.1177/2050640620957138