Patient Perspectives of Bowel Urgency and Bowel Urgency-Related Accidents in Ulcerative Colitis and Crohn's Disease

Vipul Jairath; Theresa Hunter Gibble; Alison Potts Bleakman; Kaitlin Chatterton; Paolo Medrano; Megan McLafferty; Brittany Klooster; Sonal Saxena; Richard Moses

doi:10.1093/ibd/izae044

Patient Perspectives of Bowel Urgency and Bowel Urgency-Related Accidents in Ulcerative Colitis and Crohn's Disease

Inflamm Bowel Dis. 2024 Mar 21:izae044. doi: 10.1093/ibd/izae044. Online ahead of print.

Authors

Vipul Jairath¹, Theresa Hunter Gibble², Alison Potts Bleakman², Kaitlin Chatterton³, Paolo Medrano³, Megan McLafferty³, Brittany Klooster³, Sonal Saxena², Richard Moses²

Affiliations

¹ Division of Gastroenterology, Department of Medicine, Western University, London, Ontario, OX3 9DU, Canada.
² Eli Lilly and Company, Indianapolis, IN, USA.
³ Patient-Centered Outcomes, Adelphi Values, Boston, Massachusetts, USA.

PMID: 38513272
DOI: 10.1093/ibd/izae044

Abstract

Background: Bowel urgency is bothersome in patients with ulcerative colitis (UC) or Crohn's disease (CD) and impacts their well-being but remains underappreciated in clinical trials and during patient-healthcare provider interactions. This study explored the experiences of bowel urgency and bowel urgency-related accidents to identify the concepts most relevant and important to patients.

Methods: Adults with a diagnosis of moderate-to-severe UC or CD for ≥6 months and experience of bowel urgency in the past 6 months were included. Qualitative, semi-structured interviews were conducted via telephonic/Web-enabled teleconference. Interview transcripts were coded and analyzed in ATLAS.ti 9 using a systematic thematic analysis.

Results: In total, 30 participants with UC or CD (n = 15 each) (mean age 52 and 50 years, respectively) participated in the interviews. The majority of participants were receiving biologic and/or conventional therapy (80% and 87%, respectively). Most participants with UC (87%) and all with CD experienced bowel urgency-related accidents. The most frequently reported symptoms co-occurring with bowel urgency were abdominal pain, fatigue, and abdominal cramping. Abdominal pain and abdominal cramping were the most bothersome co-occurring symptoms of bowel urgency and bowel urgency-related accidents. In both groups, participants reported decreased frequency of bowel urgency and not wanting to experience bowel urgency-related accidents at all as a meaningful improvement.

Conclusions: Participants with UC or CD expressed bowel urgency and bowel urgency-related accidents to be bothersome and impactful on their daily lives despite use of biologic and/or conventional therapy. These findings underscore the need for development of patient-reported outcome measures to assess bowel urgency in clinical settings.

Keywords: Crohn’s disease; bowel urgency; patient-reported outcomes; ulcerative colitis.

Plain language summary

Bowel urgency and bowel urgency-related accidents are accompanied by several bothersome symptoms and considerably impact patients’ quality of life, highlighting the need to develop a patient-reported outcome measure for assessing and addressing bowel urgency in clinical settings.

Grants and funding

Eli Lilly and Company