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Validation of the Urgency Numeric Rating Scale and correlation with endoscopic, histological, and manometric activity
Andreia Guimarães1, Ana Célia Caetano1,2, Inês Barbosa2
1Gastrenterology Department, Braga Local Health Unit.
Introduction And Objectives:
The Urgency Numeric Rating Scale (U-NRS) assesses the severity of bowel urgency, a common symptom that is often underestimated in ulcerative colitis. This study aimed to translate the U-NRS into Portuguese and to provide validation in clinical practice, as well as to assess the prevalence of bowel urgency in a cohort of ulcerative colitis patients and, in those in clinical remission, to evaluate its relationship with endoscopic and histological activity and manometric changes.
Methods:
After translation of the U-NRS into Portuguese, patients with ulcerative colitis seen at the outpatient clinic were asked to complete the scale at T0, after 2 weeks (T1) and after 3 months (T2). Patient-reported outcome-2 ulcerative colitis (PRO-2-UC), EQ-5D, EQ-Visual Analogue Scale (EQ-VAS), inflammatory bowel disease disk (IBD-Disk), and the Global Perceived Effect Scale were also completed. Acceptability, reliability, construct validity, responsiveness, and interpretability were assessed. A subgroup of patients in clinical remission with bowel urgency underwent sigmoidoscopy with rectal biopsies and anorectal manometry and were compared with a control group (in clinical remission without bowel urgency).
Results:
In total, 126 patients were included, of whom 49.21% ( n = 62) had bowel urgency. Test-retest reliability was excellent (intraclass correlation coefficient: 0.768). The U-NRS correlated significantly with the PRO-2-UC, IBD-Disk, EQ-VAS, and EQ-5D ( P < 0.001), demonstrating construct validity. The U-NRS values correlated with the first constant sensation volume on anorectal manometry ( rs = -0.374, P = 0.038).
Conclusion:
The U-NRS scale is an easy and quick tool for assessing bowel urgency and can be incorporated into clinical practice.
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