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The True Impact of Bowel Urgency

Doctor looking on as ulcerative colitis patient runs away from bar with bowel urgency

Hypothetical patient

Bowel Urgency Is an Important and Distinct Symptom of Ulcerative Colitis (UC) That May Exist Even When Other Symptoms Are Controlled1,2*

*Based on a study conducted in Japan (n=501)

Many people with UC suffer from bowel urgency.3†

  • In a study, 50% of the patients with UC reported experiencing urgency at least once a day
  • 84% reported experiencing urgency within the past 6 months

†Based on an IBD questionnaire conducted in Poland (N=71, UC n=38, CD n=33).

In a study of patients with UC, urgency was still experienced in1‡:

  • 39% of patients who had normal stool frequency
  • 35% of patients who had no rectal bleeding

‡Based on a study conducted in Japan (n=501, n=473 Stool Frequency (excluded those with surgery), and n=458 Rectal Bleeding (excluded those with surgery and who answered 'unknown'))

Urgency and the Stress and Panic It May Cause Can Have a Significant Impact on Quality of Life for Your Patients With UC4,5§

In a study of patients with UC, urgency is one of their most disruptive symptoms. In fact, roughly 90% of patients with UC reported urgency as a symptom that disrupts their everyday life.5|| In one survey, patients with UC chose urgency as their most important symptom and ranked it higher than abdominal pain, rectal bleeding, and stool frequency.6¶

§Studies were conducted in the UK (n=583, UC=302) and Spain (n=98).
||Study was conducted in Spain (n=98).
Choice-based conjoint analysis (CBCA) survey with 129 inflammatory bowel disease (IBD) patients. Patients diagnosed with CD were more likely to perceive abdominal pain as more important compared to patients diagnosed with UC or IBD-unclassified (IBD-U) (P=0.023), while patients diagnosed with UC or IBD-U were more likely to perceive urgency as more important compared to people with CD (P=0.026). However, the results consistently showed that in all subpopulations, urgency is the most important symptom, followed by abdominal pain, blood in stools, and frequent stools—demonstrating the need to re-weigh existing scores based on patient preferences in all subpopulations.

More than 70% of patients rated urgency as having a high impact on their quality of life.7#

#Based on an international IBD study (UC n=650).

Bowel Urgency May Keep Patients With UC From Fully Engaging in Life7,8**

**Based on IBD studies in the US (N=27, UC=21) and an international IBD study (N=2398, UC=1030).

Urgency may limit patients with UC in many ways:

Academic icon

Academically and professionally

  • Urgency may limit the ability to attend work and/or school1,9††
  • In a study, roughly 1 in 4 patients with inflammatory bowel disease (IBD) withdrew from work and/or school1,9††

    ††Based on IBD and UC studies conducted in Japan and Ireland (n=240).

Social icon

Socially

  • Urgency—and the fear of an accident—can trap IBD patients in a stressful pattern of panic, planning, and avoidance4,8‡‡
  • Urgency might limit participation in physical activity and exercise10§§

    ‡‡Based on qualitative IBD studies in the US (N=27, UC n=21) and the UK (N=583, UC n=302).
    §§Based on an international IBD study (N=834, UC n=413).

Sexual activity icon

Sexually

  • The fear of having a bowel urgency accident during intercourse may cause patients with UC to refrain from sexual activity4||||

    ||||Based on an IBD study conducted in the UK (N=611, UC n=302).

In a study, 72% of patients with UC said urgency had the greatest impact on quality of life.7¶¶

¶¶Study was conducted internationally (n=1030).

Jon’s Story: How Bowel Urgency Impacted His Social Life

Hypothetical ulcerative colitis patient Jon concerned about bowel urgency

Hypothetical patient

Jon is a 26-year-old who just moved to a new town. He is confident in himself for the most part but worries that his UC symptoms, like urgency, will act up and disrupt his life. While on a first date, his fears were realized: They had just ordered dinner when Jon felt a sudden and uncontrollable urge to defecate. With no time to explain, he had to abruptly abandon his date and run to the bathroom. He barely made it in time, and the date ended shortly after.

Jon was too embarrassed to tell anyone about the incident, including his gastroenterologist. Since his urgency emergency, Jon has not even considered dating again and is reluctant to meet new people.

Urgency and Urgency Accidents Can Lead to Patients Feeling Trapped and Not in Control4,11##

##Based on qualitative studies conducted in the UK and the US.

The unpredictable and uncontrollable nature of bowel urgency can create intense focus on bowel needs for patients with UC.11 Urgency and urgency accidents may cause patients to leave social situations so that they don't attract unwanted attention and risk exposure.4##

##Based on qualitative IBD study conducted in the UK (N=611, UC n=302).

Bowel urgency and bowel urgency accidents may limit patients with UC from reaching their full potential—academically, professionally, socially, and personally.4,8,12

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Thumbnail for ulcerative colitis patient Bruna\'s story on bowel urgency

“It’s too humiliating to explain . . . even to my doctor. So, when he didn’t ask, I didn’t tell my story.”
– Bruna, Urgency Anonymous™

Watch colleagues and leading experts in UC discuss stories based on patient experiences about the true impact of bowel urgency.


URGENCY ANONYMOUS™

References:

  1. Hibi T, Ishibashi T, Ikenoue Y, Yoshihara R, Nihei A, Kobayashi T. Ulcerative colitis: disease burden, impact on daily life, and reluctance to consult medical professionals: results from a Japanese internet survey. Inflamm Intest Dis. 2020;5:27-35. doi:10.1159/000505092
  2. Rubin DT, Ananthakrishnan AN, Siegel CA, Sauer BG, Long MD. ACG clinical guideline: ulcerative colitis in adults. Am J Gastroenterol. 2019;114:384-413. doi:10.14309/ajg.0000000000000152
  3. Petryszyn PW, Paradowski L. Stool patterns and symptoms of disordered anorectal function in patients with inflammatory bowel diseases. Adv Clin Exp Med. 2018;27(6):813-818. doi:10.17219/acem/68986
  4. Dibley L, Norton C. Experiences of fecal incontinence in people with inflammatory bowel disease: self-reported experiences among a community sample. Inflamm Bowel Dis. 2013;19(7):1450-1462. doi:10.1097/MIB.0b013e318281327f
  5. Carpio D, López-Sanromán A, Calvet X, et al. Perception of disease burden and treatment satisfaction in patients with ulcerative colitis from outpatient clinics in Spain: UC-LIFE survey. Eur J Gastroenterol Hepatol. 2016;28(9):1056-1064. doi:10.1097/MEG.0000000000000658
  6. van Deen WK, Obremskey A, Moore G, van den Akker-van Marle ME, Doctor JN, Hwang C. An assessment of symptom burden in inflammatory bowel diseases to develop a patient preference-weighted symptom score. Qual Life Res. 2020;29(12):3387-3396. doi:10.1007/s11136-020-02606-2
  7. Rubin DT, Sninsky C, Siegmund B, et al. International perspectives on management of inflammatory bowel disease: opinion differences and similarities between patients and physicians from the IBD GAPPS survey. Inflamm Bowel Dis. 2021;izab006. doi:10.1093/ibd/izab006
  8. Devlen J, Beusterien K, Yen L, Ahmed A, Cheifetz AS, Moss AC. The burden of inflammatory bowel disease: a patient-reported qualitative analysis and development of a conceptual model. Inflamm Bowel Dis. 2014;20(3):545-552. doi:10.1097/01.MIB.0000440983.86659.81
  9. Farrell D, McCarthy G, Savage E. Self-reported symptom burden in individuals with inflammatory bowel disease. J Crohns Colitis. 2016;10(3):315-322. doi:10.1093/ecco-jcc/jjv218
  10. Tew GA, Jones K, Mikocka-Walus A. Physical activity habits, limitations, and predictors in people with inflammatory bowel disease: a large cross-sectional online survey. Inflamm Bowel Dis. 2016;22(12):2933-2942. doi:10.1097/MIB.0000000000000962
  11. Newton L, Randall JA, Hunter T, et al. A qualitative study exploring the health-related quality of life and symptomatic experiences of adults and adolescents with ulcerative colitis. J Patient Rep Outcomes. 2019;3(1):66. doi:10.1186/s41687-019-0154-x
  12. Lesnovska KP, Frisman GH, Hjortswang H, Börjeson S. Critical situations in daily life as experienced by patients with inflammatory bowel disease. Gastroenterol Nurs. 2016;39(3):195-203. doi:10.1097/SGA.0000000000000211
  13. Casellas F, Herrera-de Guise C, Robles V, Navarro E, Borruel N. Patient preferences for inflammatory bowel disease treatment objectives. Dig Liver Dis. 2017;49(2):152-156. doi:10.1016/j.dld.2016.09.009