Back

P1247 - Evaluation of Somatic Pain Distribution Using Body Maps for Patients With Chronic Abdominal Pain Syndromes

Monday, October 28

10:30 AM - 4:15 PM

Location: Exhibit Halls 3 and 4 (Street Level)

Presenting Author(s)

Vasiliki Aivaliotis, MD

Redwood City, California

Vasiliki I. Aivaliotis, MD¹, Jennifer M. Hah, MD¹, Luke Pirrotta, BS², Linda A. Nguyen, MD¹

¹Stanford Hospital, Redwood City, CA; ²Stanford University School of Medicine, Palo Alto, CA

Introduction: Chronic abdominal pain (CAP) is a widespread condition with a large impact on the healthcare field. Understanding the characteristics of patients with CAP and identifying high risk patients remains an important issue, particularly in the opioid epidemic era. A body map is a validated tool shown to accurately depict pain locations across the body. Our aim was to use body map data to characterize the pain distribution patterns of patients referred for abdominal pain to the Stanford Pain Clinic and to assess whether patterns of pain distribution (e.g. localized abdominal pain vs. widespread pain) are associated with underlying diagnoses and differences in psychosocial functioning.

Methods: We evaluated patients with CAP who presented to the Stanford Pain Clinic between 2013-2018. Data was collected through the CHOIR registry - a platform that longitudinally collects data for patients seen at our pain clinic. Patients were divided into 3 groups by their body map response: Localized (abdominal pain), Intermediate (abdominal pain + pain at 1-3 additional sites), and Widespread (abdominal pain + pain at 4-8 additional sites). We evaluated demographics, ICD-codes, and psychosocial functioning with NIH PROMIS questionnaires. Analysis was performed using descriptive statistics, one-way ANOVA for the PROMIS scores, and the Kruskall-Wallis test for comparing measures across the 3 groups.

Results: A total of 258 patients with abdominal pain were identified through the CHOIR registry. The majority of the patients were female (91%) and had widespread pain patterns (61%). Patients with widespread pain patterns reported higher pain interference (p< 0.01), anxiety (p< 0.05), and sleep disturbances (p< 0.01) compared to the intermediate pain group. Patients with widespread pain were more likely to carry a diagnosis of 2 or more chronic overlapping pain conditions (p< 0.001). Opioid use remained high in all patients, regardless of somatic distribution pattern.

Discussion: Our study supports that a body map is an effective and quick screening tool to help characterize CAP patients and identify higher risk patients. Identifying patients with widespread pain patterns early may help guide therapeutic interventions towards factors more prominent in this group such as pain interference, anxiety and sleep disturbance. Patients with widespread pain patterns are more likely to also suffer from chronic overlapping pain syndromes and should be screened for these conditions.

Somatic pain distribution patterns for patients reporting abdominal pain are shown in this figure as a heat map. The number of patients reporting pain at various locations in the body is listed directly over the affected site.

The table shows baseline patient demographics, diagnoses/ICD-10 codes, opioid use, and frequency of chronic overlapping pain conditions.

Mean baseline physical/psychosocial functioning scores with the NIH PROMIS Questionnaires are shown by pain distribution pattern. Patients with widespread pain patterns reported higher pain interference (p<0.01) and anxiety (p<0.05) scores compared to intermediate pain pattern group.

Disclosures:

Vasiliki Aivaliotis indicated no relevant financial relationships.

Jennifer Hah indicated no relevant financial relationships.

Luke Pirrotta indicated no relevant financial relationships.

Linda Nguyen: allergan – Grant/Research Support. allergan – Consultant, Speaker's Bureau. ironwood – Consultant, Speaker's Bureau. ironwood – Consultant. neurogastryx – Consultant. Salix – Consultant, Speaker's Bureau.

Citation: Vasiliki I. Aivaliotis, MD; Jennifer M. Hah, MD; Luke Pirrotta, BS; Linda A. Nguyen, MD. P1247 - EVALUATION OF SOMATIC PAIN DISTRIBUTION USING BODY MAPS FOR PATIENTS WITH CHRONIC ABDOMINAL PAIN SYNDROMES. Program No. P1247. ACG 2019 Annual Scientific Meeting Abstracts. San Antonio, Texas: American College of Gastroenterology.