Wespi Nadia, Vavricka Stephan, Brand Stephan, Aepli Patrick, Burri Emanuel, Misselwitz Benjamin, Seibold Frank, Hruz Petr, Peyrin-Biroulet Laurent, Schoepfer Alain, Biedermann Luc, Sokollik Christiane, Rogler Gerhard, Greuter Thomas
Department of Gastroenterology and Hepatology, University Hospital Zurich and University of Zurich, Zurich, Switzerland.
Division of Gastroenterology and Hepatology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland.
United European Gastroenterol J. 2025 Apr;13(3):392-401. doi: 10.1002/ueg2.12657. Epub 2024 Sep 8.
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).
We performed an online patient and physician survey to evaluate the assessment, prevalence and impact of fecal urgency and incontinence in IBD.
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).
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.
尽管人们对粪急、粪失禁以及炎症性肠病（IBD）患者与医生认知差异的普遍性的认识日益增加，但对此了解甚少。
我们开展了一项在线患者和医生调查，以评估IBD中粪急和粪失禁的评估、普遍性及影响。
共有593名患者（44.0%为溃疡性结肠炎（UC），53.5%为克罗恩病（CD），2.2%为不确定性结肠炎，2例未明确说明）完成了调查（65.8%为女性，平均年龄47.1岁）。经常报告有粪急情况（UC：98.5%，CD：96.2%），甚至在缓解期也很普遍（UC：65.9%，CD：68.5%）。粪急对日常活动有很大影响（视觉模拟量表[VAS]评分为5，四分位间距为3 - 8）。然而，22.8%的患者从未与医生讨论过粪急问题。44.7%的患者经历过粪失禁，每周出现粪失禁的患者占7.9%。20.4%的患者每月至少需要使用一次尿布/尿垫。然而，29.7%的患者从未与医生谈论过粪失禁问题。UC是中重度粪急（比值比[OR] 1.65，95%置信区间[CI] 1.13 - 2.41）和粪失禁（OR 1.77，95% CI 1.22 - 2.59）存在的独立预测因素。所有医生均声称会定期询问粪急和粪失禁情况。然而，与患者反馈相比，这些症状对日常活动的影响被高估了（VAS中位数为8对5，p = 0.0113，以及9对5，p = 0.0187）。
粪急和粪失禁是IBD中令人负担沉重的症状，在UC和CD中的患病率相似。发现医生与患者的认知存在差异。这些症状应在门诊就诊时予以关注。
