Abstract
BackgroundMany patients with ulcerative colitis (UC) in clinical remission frequently complain of bowel symptoms such as increased stool frequency (SF) and rectal bleeding (RB). However, studies on these patient-reported outcomes in patients with inactive UC are limited, especially in Korea. Therefore, we investigated the prevalence and risk factors of bowel symptoms in Korean patients with inactive UC.MethodsWe investigated the prevalence of bowel symptoms in patients with endoscopically quiescent UC between June 1989 and December 2016 using a well-characterized referral center-based cohort. The Mayo clinic score (MCS) was used to evaluate bowel symptoms at the most recent visit near the date of endoscopy. Clinical characteristics of the patients were compared based on the presence or absence of bowel symptoms.ResultsOverall, 741 patients with endoscopically quiescent UC were identified, of whom 222 (30%) and 48 (6.5%) had an SF and RB subscore of ≥ 1, respectively. Patients with bowel symptoms (SF + RB ≥ 1; n = 244 [32.9%]) had higher rates of left-sided colitis (E2) or extensive colitis (E3) than patients without bowel symptoms (SF + RB = 0; n = 497 [67.1%]; P = 0.002). Multivariate analysis revealed that female sex (odds ratio [OR]: 1.568; 95% confidence interval [CI]: 1.023–2.402; P = 0.039) and E2 or E3 (OR 1.411; 95% CI 1.020–1.951; P = 0.038) were the significant risk factors for increased SF.ConclusionsThis study revealed that one-third of patients with endoscopically quiescent UC reported increased SF. Female sex and disease extent may be associated with bowel symptoms.
Highlights
Many patients with ulcerative colitis (UC) in clinical remission frequently complain of bowel symptoms such as increased stool frequency (SF) and rectal bleeding (RB)
Many patients with UC who receive appropriate medical treatment can stay in remission with mild disease activity, and recent studies have reported that colectomy rates have significantly decreased among these patients [7,8,9]
The prime therapeutic target in patients with UC is endoscopic mucosal healing [10], a growing interest has been noted in evaluating patient-reported outcomes (PROs) regarding the disease activity
Summary
Many patients with ulcerative colitis (UC) in clinical remission frequently complain of bowel symptoms such as increased stool frequency (SF) and rectal bleeding (RB). Studies on these patient-reported outcomes in patients with inactive UC are limited, especially in Korea. The prime therapeutic target in patients with UC is endoscopic mucosal healing [10], a growing interest has been noted in evaluating patient-reported outcomes (PROs) regarding the disease activity. Stool frequency (SF) and rectal bleeding (RB) are commonly evaluated PROs. Mayo clinic score (MCS) and Truelove and Witt’s score, the most commonly used disease activity and severity indexes for UC, both include SF and RB. PROs that include SF and RB have presented good correlation with disease activity of UC [13]
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