ABSTRACT
It is widely acknowledged that inflammatory bowel disease (IBD) is associated with a high prevalence of sexual dysfunction (SD). However, there is a notable paucity of specific literature in this field. This lack of information impacts various aspects, including the understanding and comprehensive care of SD in the context of IBD. Furthermore, patients themselves express a lack of necessary attention in this area within the treatment of their disease, thus creating an unmet need in terms of their well-being. The aim of this position statement by the Spanish Working Group on Crohn's Disease and Ulcerative Colitis (GETECCU) is to provide a review on the most relevant aspects and potential areas of improvement in the detection, assessment, and management of SD in patients with IBD and to integrate the approach to sexual health into our clinical practice. Recommendations are established based on available scientific evidence and expert opinion. The development of these recommendations by GETECCU has been carried out through a collaborative multidisciplinary approach involving gastroenterologists, gynecologists, urologists, surgeons, nurses, psychologists, sexologists, and, of course, patients with IBD.
ABSTRACT
Inflammatory Bowel Diseases (IBD) are a group of chronic, inflammatory disorders of the gut. The incidence and activity of IBD are determined by both genetic and environmental factors. Among these factors, polymorphisms in genes related to autophagy and the consumption of non-steroidal anti-inflammatory drugs (NSAIDs) have been consistently associated with IBD. We show that NSAIDs induce mitochondrial stress and mitophagy in intestinal epithelial cells. In an altered mitophagy context simulating that observed in IBD patients, NSAID-induced mitochondrial stress leads to the release of mitochondrial components, which act as Danger Associated Molecular Patterns with pro-inflammatory potential. Furthermore, colonic organoids from Crohn's disease patients and healthy donors show activation of the mitochondrial Unfolded Protein Response (UPRmt) upon treatment with ibuprofen. Finally, colon biopsies from Crohn's disease patients in remission or with low-to-moderate activity also show expression of genes involved in UPRmt, while patients with severe activity show no increase compared to healthy donors. Our results suggest the involvement of mitochondria in the mechanisms triggering inflammation in IBD after NSAID use. Moreover, our results highlight the clinical relevance of mitochondrial stress and activation of the UPRmt pathway in the pathophysiology of Crohn's disease.
ABSTRACT
Objetivo: Conocer la asociación entre el nivel socioeconómico que presentaban los pacientes diagnosticados de dolor crónico que acudían a la Unidad del Dolor y su adaptación al dolor crónico en términos de dolor, discapacidad y estado de ánimo. Material y método: Se realizó un estudio correlacional con una muestra de pacientes con dolor crónico que acudían a la Unidad del Dolor del Hospital Carlos Haya de Málaga. Mediante el uso de autoinformes que fueron administrados de forma oral, se midieron las siguientes variables: el nivel socioeconómico, el dolor, la discapacidad y el estado de ánimo. Se aplicó un ANOVA para comparar a los pa cientes en función del nivel socioeconómico (NSE). Resultados: El grupo NSE bajo, formado mayoritariamente por mujeres (85,7%), presentaban un dolor más incapacitante para las actividades de la vida diaria y consumían más medicación. Conclusión: Los resultados revelan que las condiciones socioeconómicas pueden suponer un factor de riesgo de una experiencia más desadaptativa del dolor crónico.
Objective: To determine the association between the socioeconomic status of patients diagnosed with chronic pain entering the Pain Unit and their adaptation to chronic pain in terms of pain, disability and mood. Method: This is a cross-sectional study of 133 chronic pain patients attending the Pain Unit at the Carlos Haya Hospital in Málaga. By means of oral self-reports the following variables were measured: socioeconomic level, pain and discomfort, disability and mood. An ANOVA test was used to compare patients according to their Socioeconomic Status (SES). Results: The low SES group had more disabling pain for daily activities and took more medication. The low NSE group consisted mainly of women (85.7%). Conclusion: The results reveal that socioeconomic conditions may be a risk factor for more disabling chronic pain.
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Aged, 80 and over , Chronic Pain/epidemiology , Chronic Pain/psychology , Pain Clinics , Adaptation, Psychological , Affect , Analysis of Variance , Chronic Pain/nursing , Disability Evaluation , Sex Distribution , Social Class , Socioeconomic Factors , Surveys and QuestionnairesABSTRACT
Inflammatory bowel disease (IBD) interferes with the daily activities of affected individuals and impairs their quality of life. The psychological factors related to IBD play an important role since they negatively affect the course of the disease and the patients' general wellbeing. Thus, stress, anxiety and depressed mood are highly frequent in patients with IBD and are associated with an increase in recurrences and symptom severity. Psychological treatments have been shown to improve the course of the disease by decreasing emotional distress. In addition, a good physician-patient relationship favors communication, trust and joint decision making. IBD requires a multidimensional approach in which psychological treatment forms part of the effective management of the disease.
Subject(s)
Inflammatory Bowel Diseases/psychology , Inflammatory Bowel Diseases/therapy , Physician-Patient Relations , Social Support , HumansABSTRACT
La enfermedad infl amatoria intestinal (EII) interfi ere en la vida diaria de los pacientes afectando a su calidad de vida. Los factores psicológicos relacionados con la EII desempeñan un papel muy importante, ya que infl uyen negativamente en el curso de la enfermedad y en el bienestar general de los pacientes. Así, se observa que las manifestaciones de estrés, ansiedad y del estado de ánimo deprimido son muy frecuentes en pacientes con EII y, además, se relacionan con el aumento de las recaídas y la gravedad de los síntomas. En este sentido, se ha comprobado que los tratamientos psicológicos mejoran el curso de la enfermedad disminuyendo el malestar emocional. Por otra parte, una buena relación entre el médico y el paciente favorece la comunicación, la confi anza y la toma de decisiones conjuntas. La EII requiere de un enfoque multidimensional donde el tratamiento psicológico forma parte de un abordaje efi caz de la enfermedad (AU)
Infl ammatory bowel disease (IBD) interferes with the daily activities of affected individuals and impairs their quality of life. The psychological factors related to IBD play an important role since they negatively affect the course of the disease and the patients general wellbeing. Thus, stress, anxiety and depressed mood are highly frequent in patients with IBD and are associated with an increase in recurrences and symptom severity. Psychological treatments have been shown to improve the course of the disease by decreasing emotional distress. In addition, a good physician-patient relationship favors communication, trust and joint decision making. IBD requires a multidimensional approach in which psychological treatment forms part of the effective management of the disease (AU)
Subject(s)
Humans , Inflammatory Bowel Diseases/complications , Inflammatory Bowel Diseases/therapy , Physician-Patient Relations , Social SupportABSTRACT
En este estudio se analizan las posibles relaciones entre las creencias de dolor, las estrategias de afrontamiento (autoafirmaciones), el dolor percibido y el estado de ánimo deprimido en pacientes con dolor crónico. Se propone un modelo teórico que es contrastado en dos muestras de pacientes que acuden a diferentes servicios médicos para tratar su dolor, concretamente 100 pacientes de Reumatología y 114 de la Unidad del Dolor. Los resultados ponen de manifiesto la existencia de diferencias en cuanto a las relaciones entre las variables estudiadas en pacientes con dolor crónico de diferentes servicios médicos. Como conclusiones generales se destaca que las creencias mantenidas ponlos pacientes influyen sobre la percepción de su dolor, sin embargo, no se encuentran relaciones significativas entre el tipo de autoafirmaciones empleadas y dolor percibido. Finalmente, el dolor que el paciente percibe y el estado emocional deprimido correlacionan positivamente (AU)
This study analyses the relationship between pain-related beliefs, coping strategies (self-statements), pain perception, and depressive mood state in chronic pain patients. A theoretical model is proposed and tested with two groups of chronic patients attending two different medical services. The sample was made up of 100 patients from the Rheumatology Unit, and 114 patients from a Pain Clinic. The results suggest that there are differences in the relationships between the different variables studied. A general conclusion is that the pain-related beliefs of patients with chronic pain play a important role on pain perception. However, no significant relationships were found between self-statements and pain. Finally, the pain intensity and the depressed mood are positively correlated (AU)
