P0497 Faecal Incontinence and Urgency in IBD Patients on Biologic Therapy in Remission: Prevalence and Risk Factors

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Abstract Background Despite being in clinical remission, patients with inflammatory bowel disease (IBD) on biologic therapy may experience faecal incontinence (FI) and urgency, significantly impacting their quality of life. This study aimed to determine the prevalence of FI and urgency in this population and to identify associated risk factors. Methods A cross-sectional study was conducted in a tertiary referral centre, including IBD patients in remission on biologic therapy (evaluated by partial Mayo score or Harvey-Bradshaw Index). Data on demographic and clinical characteristics were analysed, including age, sex, disease duration, previous biologic therapies, surgical history, and severity indices. FI was defined as a St. Mark’s Vaizey score ≥6, and urgency was assessed using a Visual Analog Scale (VAS) score ≥4. Statistical analysis included chi-squared, Fisher’s exact, and Wilcoxon rank sum tests. Results The study included 124 IBD patients (85 Crohn’s disease, 39 ulcerative colitis). FI was observed in 15% of patients, while urgency (VAS ≥4) was reported by 8%. Notably, 14.1% of Crohn’s disease patients in endoscopic remission (SES-CD ≤2) experienced significant FI. Risk factors significantly associated with FI included advanced age (median 49 years vs. 38 years, p=0.007), gender (male 33% vs. female 63%, p=0.014), and history of surgical interventions (58% vs. 26%, p=0.005). Urgency was more prevalent in patients requiring diapers or pads (30% vs. 5.7%, p<0.001) with no other significant factors identified. CRP and faecal calprotectin levels were not significantly associated with either FI or urgency in this cohort. Conclusion FI and urgency remain prevalent among IBD patients in clinical but also endoscopical remission on biologic therapy, underscoring the need for continued symptom monitoring and management strategies. Advanced age, gender and surgical history are key risk factors. Future studies should explore targeted interventions to mitigate these complications in this patient group.