Bowel urgency in inflammatory bowel disease: A concept analysis
Daniele Napolitano1, Mattia Bozzetti2, Valentina Vanzi3
1CEMAD, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy.
Inflammatory Bowel Diseases
|February 25, 2026
Summary
Bowel urgency in inflammatory bowel disease (IBD) is multidimensional, involving sudden, uncontrollable needs to defecate. A new framework is proposed for its assessment and management in IBD care and research.
Area of Science:
- Gastroenterology
- Clinical Psychology
- Health Services Research
Background:
- Bowel urgency is a significant, underrecognized symptom in inflammatory bowel disease (IBD).
- It severely impacts patients' quality of life but lacks consistent characterization and measurement.
- Understanding bowel urgency is crucial for effective IBD management.
Purpose of the Study:
- To define the concept of bowel urgency in IBD.
- To review current evidence on its clinical and mechanistic aspects.
- To propose a framework for its assessment and management in clinical practice and research.
Main Methods:
- A narrative concept analysis using Walker and Avant's 8-step method.
- Integration of evidence from clinical, physiological, and patient-reported outcome studies (2016-2025).
- Searches across major databases including MEDLINE, PsycInfo, Scopus, and Web of Science.
Main Results:
- Seven defining attributes of bowel urgency were identified: sudden onset, uncontrollability, limited time to toilet, fear of incontinence, anticipatory anxiety, avoidance behaviors, and persistence.
- Antecedents include rectal inflammation, hypersensitivity, altered pelvic floor function, and psychosocial factors.
- Consequences encompass emotional distress, social limitations, and increased healthcare use; current measures lack multidimensionality.
Conclusions:
- Bowel urgency is a complex construct with physiological, psychological, and behavioral dimensions.
- Systematic assessment of bowel urgency should be integrated into routine IBD care and clinical trials.
- A validated, multidimensional IBD-specific urgency measure is needed to improve symptom monitoring and patient-centered outcomes.
Keywords:
bowel urgencyclinical assessmentconcept analysisinflammatory bowel diseasepatient-reported outcomesMore Related Videos
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