THE SYMPTOM EXPERIENCE OF PERSONS WITH CROHNS DISEASE WITH ACTIVE DISEASE COMPARED TO THOSE WITH INACTIVE DISEASE-THE MAGIC IN IMAGINE STUDY

Background: The Inflammation, Microbiome, and Alimentation: Gastro-Intestinal and Neuropsychiatric Effects (IMAGINE) Strategy for Patient Oriented Research (SPOR) Chronic Disease Network is conducting a five-year multicenter prospective observational cohort study, Mind And Gut Interactions Cohort (MAGIC) in 14 centers across Canada spanning 2018-2023. We used the validated Inflammatory Bowel Disease Symptom Inventory-Short Form (IBDSI-SF) to document participants’ symptoms at baseline enrollment. In this study we report the most common symptoms reported by persons with Crohn’s disease (CD) whose IBDSI score indicated active disease (>14) and compared the prevalence of those symptoms in participants whose IBDSI score indicated inactive disease (<15).
Methods: Participants were recruited by convenience sampling mostly through referral centres. We collated all 24 symptom variables evaluated in the IBDSI-SF, a validated clinical index for IBD, and present them in order of most common for persons with an active IBDSI score. We present the prevalence of those same symptoms among persons with an inactive IBDSI-SF. All persons with CD underwent chart review to document the phenotype by Montreal Classification B1 (inflammatory), B2 (fibrostenosing) and B3 (penetrating).
Results: Of 2112 adults enrolled, 59% were female, mean age was 44.1 (+/-14.9SD) years. 1515 persons completed the IBDSI-SF in its entirety. The most common 5 symptoms were similar for those with active disease based on the IBDSI-SF score and those reporting inactive diseases, including fatigue, diarrhea, gas, bloating, and urgency (Table). Rank order of all 24 symptom categories of the IBDSI-SF had >0.9 correlation for persons with an active and those with inactive disease based on the IBDSI-SF. However, intensity of symptoms differed between those with active and inactive IBDSI-SF scores overall. (Table). Similarly, the rank order and relative distribution of the symptoms and intensity of the symptoms reported were similar between those with different disease phenotypes B1, B2 and B3. Abdominal pain was reported by 82.9% of persons with active IBDSI-SF and in 26.6% of those inactive IBDSI
Conclusion: Fatigue and diarrhea are the most common symptoms experienced by persons with CD, whether the CD is active or inactive, with frequency and intensity of those symptoms greater in the active IBDSI group. Persons considered to have inactive disease are often not symptom-free.