PATIENT PERSPECTIVES OF BOWEL URGENCY AND BOWEL URGENCY-RELATED ACCIDENTS IN ULCERATIVE COLITIS

Abstract

Abstract OBJECTIVE This study aimed to explore the Ulcerative Colitis (UC) patient experience of Bowel Urgency (BU) and BU-related accidents to identify what is most relevant and important to patients. METHODS Patients in the US were eligible to participate in this qualitative study if they were ≥18 years of age, had a diagnosis of moderate to severe UC for ≥6 months and had experienced BU in the last 6 months. Interviews were conducted to explore the signs, symptoms, and impacts related to BU and BU-related accidents. Transcripts were coded and analyzed in ATLAS.ti 9 using a systematic thematic analysis. RESULTS 15 patients with moderate to severe UC participated; majority were female (53%), white (80%), receiving biologic and/or conventional therapy (80%), and had a mean age of 51.6 years. A majority of patients (80%) indicated that they had experienced BU at least once in the last week and 33% indicated that they had experienced at least 1 BU-related accident in the last month. Participants reported a total of 13 sign and symptom concepts that co-occur with BU, with abdominal pain (87%), fatigue (80%), abdominal cramping (67%), and diarrhea (33%) being the most frequently reported (Table 1). Abdominal pain (40%) and abdominal cramping (40%) were frequently reported as the most bothersome symptoms of BU to participants. A total of 32 BU-related impact concepts were reported by participants across 16 impact domains (Table 1). The impact domains most frequently reported by participants were adaptive behaviors (100%), emotional functioning (87%), and social activities (67%). The most frequently reported impact concepts were dietary changes (73%), inability to participate in social activities (67%), and difficulty running errands (60%). Inability to participate in social activities (27%) and bathroom mapping (20%) were frequently reported as the most bothersome impacts to participants. A total of thirteen (87%) participants reported experiencing BU-related accidents. Of the 7 signs and symptoms reported by participants to co-occur with BU-related accidents, the most frequently reported were abdominal pain (77%), gas (77%), and abdominal cramping (69%) (Table 2). A total of 30 impact concepts of BU-related accidents were reported by participants across 13 impact domains (Table 2). The domains most frequently reported by participants were adaptive behaviors (100%), emotional functioning (69), and social activities (62%). The most frequently reported impact concepts were bathroom mapping (62%), inability to participate in social activities (62%), and embarrassment (54%). CONCLUSION This qualitative study revealed that BU, BU-related accidents, and BU co-occurring symptoms are bothersome, impactful on participants’ daily lives, and occur despite the use of biologic and/or conventional therapy.