Identifying, Understanding, and Managing Fecal Urgency in Inflammatory Bowel Diseases

Caron, Bénédicte; Ghosh, Subrata; Danese, Silvio; Peyrin–Biroulet, Laurent

doi:10.1016/j.cgh.2023.02.029

Cited by 9 publications

(4 citation statements)

References 346 publications

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“…Mirikizumab, a monoclonal antibody targeting the p19 subunit of interleukin 23, has also demonstrated effectiveness in reducing BU. A significantly greater proportion of patients treated with mirikizumab reported no BU at week 12 versus those receiving placebo, and this improvement was sustained through week 52 (97,98). Absence of BU was significantly associated with achievement of clinical response, clinical remission, Mayo stool frequency remission, Mayo rectal bleeding remission, Mayo endoscopic remission, histologic remission, and mucosal healing at weeks 12 and 52 (18,98).…”

Section: Treatments For Bumentioning

confidence: 99%

“…Most pharmacotherapy for UC targets the inflammation characteristic of active disease. Treatment with upadacitinib, a Janus kinase inhibitor, has been associated with significant improvements in BU alongside the achievement of clinical response and remission ( 46 , 96 , 97 ). Mirikizumab, a monoclonal antibody targeting the p19 subunit of interleukin 23, has also demonstrated effectiveness in reducing BU.…”

Section: Treatments For Bumentioning

confidence: 99%

“…Antidiarrheal agents (e.g., loperamide) can improve BU caused by both inflammatory and noninflammatory mechanisms ( 93 , 97 ). In cases where BU is driven by a functional bowel disorder such as IBS, anti-inflammatory therapies may not be effective.…”

Section: Treatments For Bumentioning

confidence: 99%

“…However, in the main analysis (N = 136), patients receiving placebo experienced significantly fewer days with BU versus those treated with mesalazine ( 99 ). In quiescent IBD (i.e., symptomatic control), tricyclic antidepressants (e.g., amitriptyline, nortriptyline, and desipramine) have improved refractory symptoms including BU ( 97 , 100 ).…”

Section: Treatments For Bumentioning

confidence: 99%

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Bowel Urgency in Ulcerative Colitis: Current Perspectives and Future Directions

et al. 2023

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Bowel urgency, the sudden or immediate need for a bowel movement, is one of the most common and disruptive symptoms experienced by patients with ulcerative colitis. Distinct from the separate symptom of increased stool frequency, bowel urgency has a substantial negative impact on quality of life and psychosocial functioning. Among patients with ulcerative colitis, bowel urgency is one of the top reasons for treatment dissatisfaction and one of the symptoms patients most want improved. Patients may not discuss bowel urgency often due to embarrassment, and healthcare providers may not address the symptom adequately due to lack of awareness of validated tools and/or knowledge of the importance of assessing bowel urgency. The mechanism of bowel urgency in ulcerative colitis is multifactorial and includes inflammatory changes in the rectum that may be linked to hypersensitivity and reduced compliance of the rectum. Responsive and reliable patient-reported outcome measures of bowel urgency are needed to provide evidence of treatment benefits in clinical trials and facilitate communication in clinical practice. This review discusses the pathophysiology and clinical importance of bowel urgency in ulcerative colitis and its impact on quality of life and psychosocial functioning. Patient-reported outcome measures developed to assess the severity of bowel urgency in ulcerative colitis are discussed alongside overviews of treatment options and clinical guidelines. Implications for the future management of ulcerative colitis from the perspective of bowel urgency are also explored.

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Section: Treatments For Bumentioning

confidence: 99%