Chung Sang Tse, Melissa G Hunt, Lily A Brown, Sara N Horst, Samir A Shah, Sumona Saha, Megan K Lutz, Sasha Taleban, Hannah Wf Goodrich, S Alandra Weaver, Raymond K Cross, James D Lewis, Crohn’s and Colitis Foundation’s Clinical Research Alliance’s ADEPT study team
Bowel urgency occurs in 75% of patients with UC without diarrhea or rectal bleeding and is strongly associated with disability. Illness perceptions, self-efficacy, and health-related social needs mediate bowel urgency and disability.
BACKGROUND AND AIMS: Bowel urgency is a distressing and disruptive symptom in adults with ulcerative colitis (UC). We hypothesized that bowel urgency is associated with disease-related disability and influenced by psychosocial factors.
METHODS: Hierarchical multiple linear regression assessed baseline disease symptoms (severity of bowel urgency, stool frequency, and rectal bleeding) and psychosocial factors' association with disability, using cross-sectional data from the ADEPT (Addressing Disability Effectively with Psychosocial Telemedicine) trial.
RESULTS: Among 241 adults with UC, 48% (116/241) had moderate-to-severe bowel urgency, and 75% (89/119) of participants without diarrhea or rectal bleeding experienced bowel urgency. Bowel urgency was strongly correlated with disability (ρ = 0.597; P < .0001), with mediation from negative illness perceptions, lower self-efficacy, and more health-related social needs (all P < .001). Gastrointestinal symptoms explained 40% of the variance in disability, and psychosocial factors accounted for an additional 19% (both P < .001).
CONCLUSION: Bowel urgency occurs in 75% of patients with UC without diarrhea or rectal bleeding and is strongly associated with disability. Illness perceptions, self-efficacy, and health-related social needs mediate bowel urgency and disability.