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

Bowel urgency is common in ulcerative colitis (UC), but which patients are affected, and how, has not been fully studied.

We explored associations of bowel urgency with the clinical characteristics of unselected outpatients.

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.

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.

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.