Predictors of irritable bowel syndrome-like symptoms in quiescent inflammatory bowel disease.

BACKGROUND: Many patients with quiescent inflammatory bowel disease (IBD) suffer from irritable bowel syndrome (IBS)-like symptoms. Although these symptoms cause significant reductions in quality of life, evidence-based treatments are lacking as risk factors and pathophysiology of these symptoms are not clearly defined. We aimed to identify risk factors for development of IBS-like symptoms in IBD patients with quiescent disease. METHODS: We performed a single-center retrospective cohort study of adults with IBD from 2015 to 2021. Quiescent IBD was defined by a fecal calprotectin level <250 µg/g of stool or endoscopic evidence of quiescent disease. Cox regression was performed to identify variables that were independently associated with the incident development of IBS-like symptoms in IBD patients. KEY RESULTS: A total of 368 IBD patients were included for analysis, including 278 patients with UC and 88 with Crohn's disease. 15.5% of quiescent IBD patients developed IBS symptoms, with an incidence rate of (95% CI 48.0-82.0) 63.3 per 1000 person-years. In the multivariate model, mood disorders (including anxiety and depression) and Crohn's disease were associated with increased risk for developing IBS symptoms. Male sex and higher iron levels conferred lower risk for developing IBS symptoms. Results from the multivariable model were similar in sensitivity analysis with quiescent IBD defined by fecal calprotectin level <150 mcg/g. CONCLUSIONS & INFERENCES: Mood disorder and Crohn's disease were positively associated with IBS-like symptoms in quiescent IBD, whereas male sex and iron levels were protective. Our results were robust to different fecal calprotectin levels, arguing against inflammation as a mechanism for IBS-like symptoms. This data suggests noninflammatory mechanisms may be important in the pathogenesis of IBS-like symptoms in quiescent IBD. Future work may address whether modifying these risk factors may alter disease course.

Artificial Intelligence and IBD: Where are We Now and Where Will We Be in the Future?

PURPOSE OF REVIEW: Artificial intelligence (AI) is quickly demonstrating the ability to address problems and challenges in the care of IBD. This review with commentary will highlight today's advancements in AI applications for IBD in image analysis, understanding text, and replicating clinical knowledge and experience. RECENT FINDINGS: Advancements in machine learning methods, availability of high-performance computing, and increasing digitization of medical data are providing opportunities for AI to assist in IBD care. Multiple groups have demonstrated the ability of AI to replicate expert endoscopic scoring in IBD, with expansion into automated capsule endoscopy, enterography, and histologic interpretations. Further, AI image analysis is being used to develop new endoscopic scoring with more granularity and detail than is possible using conventional methods. Advancements in natural language processing are proving to reduce laborious tasks required in the care of IBD, including documentation, information searches, and chart review. Finally, large language models and chatbots that can understand language and generate human-like replies are beginning to exhibit clinical intelligence that will revolutionize how we deliver IBD care. Today, AI is being deployed to replicate expert judgement in specific tasks where disagreement, subjectivity, and bias are common. However, the near future will herald contributions of AI doing what we cannot, including new detailed measures of IBD, enhanced analysis of images, and perhaps even fully automating care. As we speculate on future technologic capabilities that may improve how we care for IBD, this review will also consider how we will implement and fairly use AI in practice.

Predictors of siege mentality among early adults: moderating role of paranoid thoughts.

OBJECTIVE: Firstly, the study aimed to determine the effect of paranoid ideation on the prediction of siege mentality among early adults. Secondly, the study examined the effect of paranoid thoughts on the prediction of siege mentality among early adults. Thirdly, the study assessed the moderating effect of paranoid thoughts in the relationship between paranoid ideation and siege mentality among early adults. METHODS: According to the criteria, the age ranged from 17 to 45 years which refers to early adults. This cross-sectional study was conducted at Sargodha, Pakistan, comprising of 300 participants. The present study was carried out from October 2017 to October 2018. Data was collected by administering General Siege Mentality Questionnaire, Green et al Thought Questionnaire and Paranoia Questionnaire. SPSS-20 (Statistical Package for the Social Sciences) was used for data analysis. RESULTS: A total sample of 300 adults participated in the study. The correlation analysis confirmed that the paranoid ideation had positive correlation with siege mentality (p<0.01). Paranoid thoughts had positive correlation with siege mentality (p<0.01). Thus the paranoid ideation and paranoid thoughts are positive predictors of siege mentality. CONCLUSIONS: In this study, findings suggested that paranoid ideation contributed to later development of siege mentality among young adults.