Bowel urgency in ulcerative colitis assessed from patients’ reports: Results of a telemonitoring programme

BACKGROUND: Bowel urgency is common in ulcerative colitis (UC), but which patients are affected, and how, has not been fully studied. OBJECTIVE: We explored associations of bowel urgency with the clinical characteristics of unselected outpatients. DESIGN: The study included adults with UC already enrolled in a telemonitoring programme using the IBD Tool platform. Between January 2021 and May 2024, patients repeatedly completed the Simple Clinical Colitis Activity Index (P-SCCAI) and Monitor at Home IBD - Ulcerative Colitis (MIAH-UC) questionnaires, plus other questionnaires. The submission of contemporary P-SCCAI and MIAH-UC scores was an "event" for analysis. The degree of bowel urgency was determined from responses to three P-SCCAI questions. RESULTS: Overall, 277 UC patients submitted 2768 events. No urgency was reported in 1813 events (66 %), while mild urgency in 538 (19 %), moderate urgency in 272 (10 %) and severe urgency in 145 (5 %). Variables positively associated with moderate-severe urgency at multivariate analysis (P < 0.0001) were female sex, age at diagnosis, disease duration, extensive UC, higher disease activity (MIAH-UC score), higher disease-related disability (IBD Disk), and any medical treatment. In 1750 events, disease was in clinical remission (MIAH-UC ≤3.5), but moderate-severe urgency was reported in 67 (3.8 %) of them. At multivariate analysis, variables associated with urgency during UC remission were age at diagnosis, disease duration, IBD Disk score, any treatment, and female sex. CONCLUSION: Bowel urgency affects UC patients' lives and is associated with more severe disability, worse quality of life and higher depression scores. Moderate-severe urgency was reported in 1 in 25 events with UC in remission and increased the patients' disease-related disability.

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