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Self-reported flares among people living with IBD are associated with stress and worry but not associated with recent diet changes: The Manitoba Living with IBD Study.

K. Vagianos,L. Shafer,K. Witges,L. Graff,L. Targownik,C. Bernstein

Published 2022 in JPEN - Journal of Parenteral and Enteral Nutrition

ABSTRACT

BACKGROUND In this matched case-control longitudinal study among people living with inflammatory bowel disease (IBD), we investigated beliefs about what triggers a flare. METHODS Adults with confirmed IBD and active disease within 2 years were enrolled in the Manitoba Living with IBD Study and followed biweekly with online surveys for 1 year. The 7-point IBD Symptom Change Indicator was used for participant identification of a flare. Flare cases were matched to non-flare controls by sex and disease type. Members of each matched pair completed supplemental information on diet changes and psychological functioning in the previous two weeks, and provided stool samples to assess fecal calprotectin (FCAL). RESULTS Of 128 enrolled participants, 95 matched flare/non-flare pairs were created. Those reporting a flare were more likely to have elevated FCAL (51% vs 34% among non-flares, p=0.043). Although 61% of study participants believed at baseline that a food may trigger flares, and 25% of those in a flare believed that a food may have triggered their current flare, there was no difference in consumption of assessed foods between flares and non-flares in the previous two weeks. Flares were more likely to be having difficulties in emotional state than controls (40% vs 18%, p=0.001) and more likely to be stressed or worried (64% vs 33%, p=0.001). CONCLUSION While a majority of individuals with IBD believe that specific foods trigger their disease flares, this was not supported by the current findings. Recent psychological functioning was associated with self-reported IBD flare. This article is protected by copyright. All rights reserved.

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