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Background <p>A significant proportion of patients with inflammatory bowel disease (IBD) continue to experience gastrointestinal symptoms despite achieving endoscopic remission. These irritable bowel syndrome (IBS)-like symptoms may result from gut-brain axis dysfunction or low-grade immune activation.</p> Aims <p>We aimed to determine whether extra-intestinal autoimmune comorbidities are associated with IBS-like symptoms in quiescent IBD.</p> Methods <p>We conducted a retrospective cohort study of adult patients with IBD with endoscopic remission, excluding patients with prior IBS or less than 12&#xa0;months of follow-up. The primary outcome was the development of IBS-like symptoms within 12&#xa0;months of baseline colonoscopy. Multivariable Cox regression and Kaplan–Meier survival analysis were used to identify risk factors and assess time to symptom development.</p> Results <p>Among 399 patients, 80 (20.1%) developed new IBS-like symptoms within one year of achieving endoscopic remission. Mean time to symptom onset was 169.2&#xa0;days (SD 110.3). Symptom development was significantly associated with extra-intestinal autoimmune comorbidities (HR 2.05; 95% CI 1.15–3.66; <i>p</i> = 0.015) and anxiety (HR 1.87; 95% CI 1.13–3.12; <i>p</i> = 0.016). Kaplan–Meier analysis showed that patients with autoimmune comorbidities had a significantly higher cumulative incidence of IBS-like symptoms compared to those without (log-rank <i>p</i> &lt; 0.001).</p> Conclusion <p>Among patients with IBD with endoscopic remission at baseline, 20.1% developed IBS-like symptoms within one year. The presence of autoimmune comorbidity was significantly associated with earlier development of IBS-like symptoms. These findings suggest that immune system dysregulation may play a role in persistent gastrointestinal symptoms and highlight the need for further research into the pathophysiology of IBS-like symptoms in quiescent IBD.</p>

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Increased Autoimmunity Burden Is a Risk Factor for Developing Irritable Bowel Syndrome-Like Symptoms in Quiescent Inflammatory Bowel Disease

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年1月3日

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  • Andrew Chang,
  • Bita Shahrvini,
  • Janice Oh,
  • Divya P. Prajapati,
  • Mark Baniqued,
  • Rhett Harmon,
  • Alexandra C. Greb,
  • Nirupama Bonthala,
  • Jenny S. Sauk,
  • Andrea Shin,
  • Lin Chang,
  • Berkeley N. Limketkai

摘要

Background

A significant proportion of patients with inflammatory bowel disease (IBD) continue to experience gastrointestinal symptoms despite achieving endoscopic remission. These irritable bowel syndrome (IBS)-like symptoms may result from gut-brain axis dysfunction or low-grade immune activation.

Aims

We aimed to determine whether extra-intestinal autoimmune comorbidities are associated with IBS-like symptoms in quiescent IBD.

Methods

We conducted a retrospective cohort study of adult patients with IBD with endoscopic remission, excluding patients with prior IBS or less than 12 months of follow-up. The primary outcome was the development of IBS-like symptoms within 12 months of baseline colonoscopy. Multivariable Cox regression and Kaplan–Meier survival analysis were used to identify risk factors and assess time to symptom development.

Results

Among 399 patients, 80 (20.1%) developed new IBS-like symptoms within one year of achieving endoscopic remission. Mean time to symptom onset was 169.2 days (SD 110.3). Symptom development was significantly associated with extra-intestinal autoimmune comorbidities (HR 2.05; 95% CI 1.15–3.66; p = 0.015) and anxiety (HR 1.87; 95% CI 1.13–3.12; p = 0.016). Kaplan–Meier analysis showed that patients with autoimmune comorbidities had a significantly higher cumulative incidence of IBS-like symptoms compared to those without (log-rank p < 0.001).

Conclusion

Among patients with IBD with endoscopic remission at baseline, 20.1% developed IBS-like symptoms within one year. The presence of autoimmune comorbidity was significantly associated with earlier development of IBS-like symptoms. These findings suggest that immune system dysregulation may play a role in persistent gastrointestinal symptoms and highlight the need for further research into the pathophysiology of IBS-like symptoms in quiescent IBD.