Urgency Associated With Impaired Quality of Life in Patients With Ulcerative Colitis

Man holding toilet tissue roll in bathroom looking at loo
Researchers assessed associations between urgency in patients with ulcerative colitis and quality of life domains, future hospitalizations, steroid prescriptions, and colectomy.

The following article is a part of conference coverage from the Advances in Inflammatory Bowel Diseases 2021 Annual Meeting , held from December 9 to 11, 2021. The team at Gastroenterology Advisor will be reporting on the latest news and research conducted by leading experts in gastroenterology. Check back for more from AIBD 2021.


n patients with ulcerative colitis (UC), urgency is a patient-reported outcome (PRO) that is independently associated with impaired quality of life (QOL), according to research presented at the Advances in Inflammatory Bowel Diseases (AIBD) 2021 Annual Meeting, held from December 9 to 11, 2021, in Orlando, Florida and virtually.

Urgency, or the immediate need to defecate, is common in patients with UC; however, the frequently used PRO-2 for UC only includes rectal bleeding and stool frequency. Researchers aimed to evaluate associations between urgency in patients with UC with QOL domains and future UC hospitalizations, steroid prescriptions, and colectomy.

The researchers first conducted a cross-sectional study to describe associations with levels of urgency in 632 patients with UC using Patient-Reported Outcomes Measurement Information System (PROMIS) QOL domains (depression, anxiety, social satisfaction, fatigue, sleep, and pain).

After adjusting for clinical variables, rectal bleeding, and stool frequency, researchers found that compared with the questionnaire response “no hurry”, response with “hurry”, “immediately”, and “incontinence” increased the odds of social impairment by 2.05 (P =.005), 2.76 (P =.028), and 7.7 (P =.009), respectively. In addition, urgency significantly increased the odds of depression, anxiety, and fatigue.

The researchers then conducted a longitudinal study to determine the associations between baseline urgency and subsequent clinical outcomes including UC hospitalization, steroid prescription, or colectomy within 12 months.

They found that urgency was associated with a significant stepwise increase in the risk for hospitalizations, steroids, and colectomy, and that responses of “hurry”, “immediately”, and “incontinence” increased the odds of colectomy within 12 months by 1.41 (P <.0001), 1.80, and 3.29 (P <.0001).

The researchers stated, “Urgency is associated with future risk of hospitalizations, steroid prescription, and colectomy.” “Our findings support the consideration of urgency as a UC-specific PRO and its use as an outcome in clinical trials to capture [QOL] and risk of clinical decompensation,” they concluded.  

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Sninsky J, Barnes E, Zhang X, Long M. Urgency and its association with quality of life and clinical outcomes in ulcerative colitis patients. Presented at: AIBD 2021 Annual Meeting; December 9-11, 2021; Orlando, FL and virtual. Abstract P075.