Improving management of abdominal pain in inflammatory bowel disease

Introduction: Abdominal pain remains a major challenge in inflammatory bowel disease (IBD), due to its frequency and relative impact on healthcare costs and patient well-being. Although significant steps have been taken to better understand pain and how to manage this important symptom, a great deal is still unknown regarding the nature of abdominal pain, including in IBD. Areas covered: In this critical perspective, we review current major issues related to abdominal pain in IBD, along with the contemporary strategies utilized to address this symptom. Additionally, we discuss approaches that can be taken now to optimize pain control in IBD, while also providing suggestions to significantly improve management of this issue in the future. Expert opinion: IBD patients are still frequently plagued by abdominal pain, and their providers are often unable to adequately and/or safely manage this symptom. In order to significantly improve our approach in this regard, we need to utilize evidence-based strategies that are still practical, while also avoiding unhelpful (and potentially dangerous) analgesic choices. Additionally, more resources and research are necessary to take advantage of what is already known, and to further optimize our understanding of this challenging symptom.