Among people living with Crohn’s disease or ulcerative colitis, up to 70 percent experience symptoms of pain during a flare and between 20 and 50 percent experience ongoing pain during periods of remission
. This pain often reflects internal disease activity as well as psychosocial factors. Regardless of the cause, pain can play a significant part in the mental health and quality of life of people living with Crohn’s or colitis.
You want to know more about pain. We’ve heard you.
In a 2017 Crohn’s and Colitis Canada survey, people affected by Crohn’s or colitis shared how pain impacts them. Among nearly 3,500 respondents, almost 40 percent of people with Crohn’s or colitis and 30 percent of caregivers wanted to learn more about pain symptom management. Among patients’ education priorities, pain management was ranked third.
To help manage pain, researchers first need to understand it – what causes it, how patients experience it, and what factors contribute to it. Crohn’s and Colitis Canada supports a number of research projects
tackling the issue of pain prevention and management strategies for people living with IBD. Examples of these strategies include mindfulness therapies and the use of medications.
One of the pain researchers we support is Dr. Stephen Vanner, a professor of medicine, clinician-scientist, and the Director of the Gastrointestinal Diseases Research Unit at the Kingston Health Sciences Centre. Dr. Vanner’s work on bowel diseases has been instrumental in establishing the field of neurogastroenterology, a field that connects diseases of the gut with the nervous system.
Pain and Neurogastroenterology
Why does the nervous system matter in a disease of the gut? Consider the management of abdominal pain, one of the most unmet needs of inflammatory bowel disease (IBD) patients. The nervous system drives the experience of pain. Millions of nerve cells line the gut and when they are triggered by painful stimuli, they send signals to the spinal cord and brain.
Opioid-based pain relievers target nerve cells and reduce the pain signals sent to the brain. However, conventional opioids can present serious side effects such as dizziness and nausea. If we could design a way to target the delivery of pain relieving drugs to just the parts of the body that are in pain, we would avoid collateral damage, and significantly improve pain management. Dr. Vanner’s research aims to minimize potential side effects by delivering opioid-based pain relievers specifically to inflamed tissue in the gut.
Dr. Vanner’s Pain Research
With a three-year research grant from Crohn’s and Colitis Canada, Dr. Vanner and his team are testing new ways to deliver opioid drugs strategically. The end goal is to reduce abdominal pain in people with IBD while minimizing harmful side effects. Dr. Vanner shares, “Opioids are the most effective analgesics we have, but their side effects can be very harmful at times. Finding alternatives, such as opioids that only inhibit pain at the site of gut inflammation and that don’t adversely affect breathing or our brain, would be a tremendous advance.”
One example of a strategy they are testing takes advantage of the natural environment of the inflamed gut. Inflammation causes the gut tissue to become more acidic. Knowing this, Dr. Vanner is testing an opioid drug that works optimally when it is in a more acidic environment. Meaning, these drugs should have minimal effect on normal tissues and minimize the risks associated with opioid use.
With this current grant, Dr. Vanner’s research is evaluating these strategies in animal models. The findings from his studies will hopefully lead to clinical trials and improve the use of opioid drugs to manage pain in humans with IBD.
The capacity for Dr. Vanner to carry out this research did not come overnight. Over the past 25 years, Crohn’s and Colitis Canada has funded a number of Dr. Vanner’s research projects to understand the mechanism of pain in IBD and improve the pharmacological management of pain. This most recent project builds on important discoveries that he and others in his field have made through previous projects.
Recognizing Dr. Vanner’s Leadership and Research Excellence
Recently, Dr. Stephen Vanner was inducted as a Fellow of the Canadian Academy of Health Sciences (CAHS), joining the ranks of scientists and scholars who are committed to making a positive impact on the urgent health concerns of Canadians. Becoming a Fellow of the CAHS is considered one of the highest honours for Canadian health scientists. Dr. Vanner has been appointed to this position based on his leadership, academic performance, scientific creativity, and willingness to serve. He is passionate about ensuring that his work is driven by patient needs and actively engages them in his research.
Researchers like Dr. Vanner are working hard to improve the lives of people with IBD. Crohn’s and Colitis Canada is a proud supporter of Dr. Vanner’s work and delighted that his excellence is being recognized with the honour of being named a Fellow of the CAHS.
Are you experiencing pain or discomfort? Speak with your healthcare provider and check out the educational resources about pain available through our MyGut app
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Read about other research funded by Crohn’s and Colitis Canada in our Research Report.