Understanding persistent pain in Crohn’s and Colitis



Testing the nerve and brain function in people with strikingly different patterns of Ulcerative Colitis pain will help us discover new treatments and use existing ones more effectively.

Dr Michael Lee,
University of Cambridge

What the researchers will look at

Many people with Crohn's or Colitis experience regular abdominal pain, regardless of whether they are in remission or experiencing a flare. Our nervous system coordinates when and where we feel pain, as well as the intensity of the pain we feel. It's thought that the nervous system might become particularly sensitive to pain signals in the gut due to the recurrent inflammation experienced by people with Crohn's or Colitis during flares. This research project aims to find out more about the relationship between the sensitivity of the nervous system and recurrent inflammation.

Led by Dr Lee at the University of Cambridge, this research will start by surveying people with Ulcerative Colitis identified from the IBD BioResource to identify two sets of suitable participants. The first group of people will be those experiencing persistent abdominal pain even when in remission, and the second group will be those whose symptoms of abdominal pain are only experienced whilst in a flare.

Both groups will be asked further questions about the pain they experience, as well as being tested for symptoms that may be associated with small nerve fibre damage, for example, their ability to detect changes in temperature in their hands and feet. The researchers will also set up a 30-day diary system for the participants to record bowel-related symptoms that interrupt their day-to-day life. Results and data will be collected from participants’ diaries, as well as stool frequency and faecal calprotectin test results.

This research project will provide proof-of-principle evidence that nerve changes are present in people with Colitis and account for the persistent pain they experience. In doing this, the project aims to open up new avenues for research, such as increased funding for MRI or PET scanning to detect further nerve changes or inflammation in the brain.

Whilst this research focuses on people with Colitis, it’s likely that the findings related to the nervous system can be extended to those with other forms of Inflammatory Bowel Disease.

What the researchers think this might mean for people with Crohn’s and Colitis:

As part of Crohn’s & Colitis UK’s ongoing commitment to funding research that helps understand pain, this research will demonstrate the relationship between inflammation, persistent abdominal pain, and the nervous system. If successful in determining the proof-of-principle, this research could lead on to more detailed and specific nerve and brain tests combined with genetic studies that may help with pinpointing pain mechanisms in Crohn's and Colitis. This in turn could lead to the development of better pain medications with fewer disruptive side effects.

Who is leading this research: Dr Michael Lee
Our funding: £119,952
Duration: 3 years
Official title of application: Identifying susceptibility within the nervous system for pain in inflammatory bowel disease - a stage 2 IBD-BioResource cohort study