Prevalence and Factors Associated with Fecal Urgency among Patients with Ulcerative Colitis and Crohn's Disease in the Study of a Prospective Adult Research Cohort with Inflammatory Bowel Disease

Abstract

Background: In patients with ulcerative colitis (UC) and Crohn's disease (CD), this research examined the following: prevalence of fecal urgency (hereafter urgency), association of urgency with inflammatory bowel disease (IBD) symptoms and fecal calprotectin, and association between well-being and urgency. Methods: In this cross-sectional study from the Study of a Prospective Adult Research Cohort with IBD, urgency was categorized as none, mild, and moderate-severe. We examined the prevalence of urgency, association of urgency with IBD symptoms and fecal calprotectin (in a subset) using multinomial logistic regression, and association of well-being (not feeling well vs generally well) with urgency using logistic regression. Results: Among 576 UC patients, 31.4% reported mild and 28.1% moderate-severe urgency. Among 1330 CD patients, 33.8% reported mild and 31.4% moderate-severe urgency. In UC, moderate-severe urgency was associated with: increased average bowel movements/day [odds ratio (OR) 1.23; 95% confidence interval: 1.09, 1.23], increased stool frequency relative to normal (OR, 9.95; 95% CI: 3.21, 30.87), rectal bleeding (OR, 3.36; 95% CI: 1.79, 6.34), moderate-severe abdominal pain (OR, 17.5; 95% CI: 5.38, 56.89), and calprotectin ≥ 250 μg/g (OR, 4.36; 95% CI: 1.50, 12.66). In CD, moderate-severe urgency was associated with: increased average bowel movements/day (OR, 1.23; 95% CI: 1.14, 1.34), increased stool frequency relative to normal (OR, 7.57; 95% CI: 3.30, 17.34), rectal bleeding (OR, 1.77; 95% CI: 1.13, 2.78), and moderate-severe abdominal pain (OR, 7.52; 95% CI: 4.31, 13.14). Reduced well-being was associated with moderate-severe urgency in both UC (OR, 4.20; 95% CI: 1.69, 20.40) and CD patients (OR, 2.52; 95% CI: 1.51, 4.22). Conclusions: Urgency was common and associated with symptoms and biomarkers suggesting active IBD and reduced well-being.