Bowel Urgency Reflected in Patient Perceptions of UC Severity

Using the Communicating Needs and Features of IBD Experiences (CONFIDE) survey, a team of investigators sought to characterize patients’ perceptions of the severity of their ulcerative colitis (UC) based on their experiences of bowel urgency, according to a poster presented  at the American College of Gastroenterology Postgraduate Course.

CONFIDE is an online, quantitative, cross-sectional survey of patients with IBD. For the purposes of this research, inclusion required moderate-to-severe UC as defined by previous treatment experience, steroid use, and/or hospitalization. Patients who met the entry criteria were asked: “How severe do you think your UC is currently?” They could report their perception of disease as mild, moderate, severe, or do not know.

A total of 200 patients in the US (62% males, mean age 40 years) and 556 patients in 5 European countries—France, Germany, the United Kingdom, Italy, and Spain (57% males, mean age 39 years)— met study entry criteria for moderate-to-severe UC and completed the survey. The majority—71% in both the US and Europe—perceived their current disease severity as moderate.

Among patients who reported ever experiencing bowel urgency, 79% of those in the US and 71% of patients in the 5 European nations (EU5) had experienced bowel urgency at least once a week during the past 3 months, regardless of how they perceived their disease severity. Of those patients who reported ever experiencing accidents related to bowel urgency, 9% of those in the US and 13% in EU5 who perceived their disease severity as mild; 62% of US patients and 56% of European patients who perceived their disease severity as moderate; and 75% in the US compared to 57% in Europe who reported their disease perception as severe, had experienced accidents related to bowel urgency at least once a week over the previous 3 months.

A greater proportion of patients who perceived their UC as moderate (49% US, 39% EU5) or severe (43% US, 61% EU5) reported wearing some type of protection, such as a diaper or pad, at least once a week in past 3 months due to fear of bowel urgency accidents, compared to those who perceived their disease as mild (14% US, 19% EU5.)

Among those patients who had ever worn protection such as a diaper or pad at least once a week in past 3 months due to fear of bowel urgency accidents, more patients who perceived their disease as severe (67% US, 56% EU5) or moderate (50% US, 55% EU5) reported that they worked fewer hours due to bowel urgency versus those who perceived their disease as mild (17% US, 33% EU5).
 

Compared to patients with mild disease perception, patients who perceived their disease as moderate or severe more frequently reported bowel urgency, accidents related to bowel urgency, and related use of diaper or pad protection. They also reported more often that bowel urgency had an impact on work or school.

Reference:

Rubin DT, Dubinsky MC, Gibble TH, et al. P0735 - The effect of patients’ current ulcerative colitis disease severity perception on prevalence and experiences of bowel urgency: results from the communicating needs and features of IBD experiences (CONFIDE) survey. Presented at: 2023 ACG Postgraduate Course. Vancouver, Canada. October 21, 2023.