Many Patients With Ulcerative Colitis Suffer From This 'Often Neglected' Symptom

Bowel urgency affects more than a quarter of patients with ulcerative colitis (UC) and almost 10% of patients with UC in remission, according to a study presented at Digestive Disease Week 2024, taking place May 18-21 in Washington, DC.

Despite the significant impact of bowel urgency on quality of life in patients with UC, “it is often a neglected symptom and is not a component of commonly used clinical scoring systems in UC,” the researchers noted.

In this study, they aimed to assess the predictors and frequency of urgency in patients with UC based on their endoscopic and histological remission status. Researchers analyzed 205 patients with UC (median age, approximately 30.0 years; 53.7% female) who had a Mayo endoscopic score of 0 or 1 with digitized histopathological images and urgency scores within 60 days of one another. Any patient who reported needing to get to the bathroom in less than 5 minutes were categorized as having moderate-to-severe urgency. The investigators used the Mann-Whitney U test to compare disease duration, extent of macroscopic UC, and median fecal calprotectin (FCP) levels in patients with and without moderate-to-severe urgency.

The results showed that 9.1% of patients in histological remission and 27.0% of those with histologically active disease reported urgency. Histological activity (P=.003), history of hospitalization for severe UC (P=.038), disease duration (median, 7 years [urgency] vs 12 years [no urgency]; P=.001), and extent of UC (more pancolitis without urgency and more proctitis with urgency; P=.023) significantly differed between those with and without urgency.

“Urgency was reported by more than 20% of UC patients in endoscopic remission and nearly 1 in 10 patients with histologic remission. Predictors of urgency included histological activity, history of hospitalization for severe UC, shorter disease duration, and extent of UC but not FCP. These results need external validation in other prospective studies,” the researchers concluded.