Fecal urgency and incontinence in inflammatory bowel disease perceived by physician and patient: Results from the Swiss fecal urgency survey.

Autor: Wespi N; Department of Gastroenterology and Hepatology, University Hospital Zurich and University of Zurich, Zurich, Switzerland., Vavricka S; Department of Gastroenterology and Hepatology, University Hospital Zurich and University of Zurich, Zurich, Switzerland., Brand S; Division of Gastroenterology and Hepatology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland., Aepli P; Division of Gastroenterology and Hepatology, Cantonal Hospital Lucerne, Lucerne, Switzerland., Burri E; Division of Gastroenterology and Hepatology, University Medical Clinic, Cantonal Hospital Baselland, Liestal, Switzerland., Misselwitz B; Department of Visceral Surgery and Medicine, Bern University Hospital, University of Bern, Bern, Switzerland., Seibold F; Intesto Crohn and Colitis Center, Bern, Switzerland., Hruz P; Division of Gastroenterology and Hepatology, Clarunis, University Hospital Basel, Basel, Switzerland., Peyrin-Biroulet L; Department of Gastroenterology, INFINY Institute, FHU-CURE, INSERM NGERE, Nancy University Hospital, Vandœuvre-lès-Nancy, France.; Groupe Hospitalier privé Ambroise Paré - Hartmann, Paris IBD Center, Neuilly-sur-Seine, France.; Division of Gastroenterology and Hepatology, McGill University Health Centre, Montreal, Quebec, Canada., Schoepfer A; Division of Gastroenterology and Hepatology, CHUV University Hospital Lausanne and University of Lausanne UNIL, Lausanne, Switzerland., Biedermann L; Department of Gastroenterology and Hepatology, University Hospital Zurich and University of Zurich, Zurich, Switzerland., Sokollik C; Pediatric Gastroenterology, Hepatology and Nutrition, Children's Hospital, Bern University Hospital, University of Bern, Bern, Switzerland., Rogler G; Department of Gastroenterology and Hepatology, University Hospital Zurich and University of Zurich, Zurich, Switzerland., Greuter T; Department of Gastroenterology and Hepatology, University Hospital Zurich and University of Zurich, Zurich, Switzerland.; Division of Gastroenterology and Hepatology, CHUV University Hospital Lausanne and University of Lausanne UNIL, Lausanne, Switzerland.; Division of Gastroenterology and Hepatology, GZO-Zurich Regional Health Center, Wetzikon, Switzerland.
Jazyk: angličtina
Zdroj: United European gastroenterology journal [United European Gastroenterol J] 2024 Sep 08. Date of Electronic Publication: 2024 Sep 08.
DOI: 10.1002/ueg2.12657
Abstrakt: Introduction: Although increasingly appreciated, little is known about the prevalence of fecal urgency, fecal incontinence and differences between patients' and physicians' perception in inflammatory bowel disease (IBD).
Methods: We performed an online patient and physician survey to evaluate the assessment, prevalence and impact of fecal urgency and incontinence in IBD.
Results: A total of 593 patients (44.0% ulcerative colitis (UC), 53.5% Crohn's disease (CD), 2.2% indeterminate colitis, 2 not specified) completed the survey (65.8% females, mean age 47.1 years). Fecal urgency was often reported (UC: 98.5%, CD: 96.2%) and was prevalent even during remission (UC: 65.9%, CD: 68.5%). Fecal urgency considerably impacted daily activities (visual analog scale [VAS] 5, IQR 3-8). Yet, 22.8% of patients have never discussed fecal urgency with their physicians. Fecal incontinence was experienced by 44.7% of patients and 7.9% on a weekly basis. Diapers/pads were required at least once a month in 20.4% of patients. However, 29.7% of patients never talked with their physician about fecal incontinence. UC was an independent predictor for the presence of moderate-severe fecal urgency (OR 1.65, 95% CI 1.13-2.41) and fecal incontinence (OR 1.77, 95% CI 1.22-2.59). All physicians claimed to regularly inquire about fecal urgency and incontinence. However, the impact of these symptoms on daily activities was overestimated compared with the patient feedback (median VAS 8 vs. 5, p = 0.0113, and 9 vs. 5, p = 0.0187).
Conclusions: Fecal urgency and incontinence are burdensome symptoms in IBD, with a similar prevalence in UC and CD. A mismatch was found between the physician and patient perception. These symptoms should be addressed during outpatient visits.
(© 2024 The Author(s). United European Gastroenterology Journal published by Wiley Periodicals LLC on behalf of United European Gastroenterology.)
Databáze: MEDLINE
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