Abstract
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<0.0001), with mediation from negative illness perceptions, lower self-efficacy, and more health-related social needs (all P<0.001). 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.