Fecal urgency and incontinence in inflammatory bowel disease perceived by physician and patient: Results from the Swiss fecal urgency survey.

IF 5.8 2区 医学 Q1 GASTROENTEROLOGY & HEPATOLOGY
Nadia Wespi, Stephan Vavricka, Stephan Brand, Patrick Aepli, Emanuel Burri, Benjamin Misselwitz, Frank Seibold, Petr Hruz, Laurent Peyrin-Biroulet, Alain Schoepfer, Luc Biedermann, Christiane Sokollik, Gerhard Rogler, Thomas Greuter
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引用次数: 0

Abstract

Introduction: 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).

Methods: We performed an online patient and physician survey to evaluate the assessment, prevalence and impact of fecal urgency and incontinence in IBD.

Results: 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).

Conclusions: 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.

医生和患者对炎症性肠病患者排便急迫和失禁的看法:瑞士粪便紧迫感调查结果。
导言:尽管人们越来越重视排便急迫性和排便失禁,但对于炎症性肠病(IBD)中排便急迫性和排便失禁的发生率以及患者和医生的认知差异却知之甚少:我们对患者和医生进行了在线调查,以评估 IBD 中粪便紧迫感和失禁的评估、患病率和影响:共有 593 名患者(44.0% 患有溃疡性结肠炎 (UC),53.5% 患有克罗恩病 (CD),2.2% 患有不确定结肠炎,2 名患者不详)完成了调查(65.8% 为女性,平均年龄 47.1 岁)。大便急迫症经常出现(UC:98.5%,CD:96.2%),甚至在病情缓解期间也很普遍(UC:65.9%,CD:68.5%)。便急严重影响日常活动(视觉模拟量表 [VAS] 5,IQR 3-8)。然而,22.8% 的患者从未与医生讨论过便急问题。44.7%的患者会出现大便失禁,7.9%的患者每周都会出现大便失禁。20.4%的患者每月至少需要使用一次尿布/尿垫。然而,29.7%的患者从未与医生讨论过大便失禁问题。UC 是中度-重度便急症(OR 1.65,95% CI 1.13-2.41)和大便失禁(OR 1.77,95% CI 1.22-2.59)的独立预测因子。所有医生都声称会定期询问有关便急和失禁的情况。然而,与患者的反馈相比,这些症状对日常活动的影响被高估了(VAS 中位数为 8 vs. 5,p = 0.0113;9 vs. 5,p = 0.0187):结论:大便急迫和失禁是 IBD 的常见症状,在 UC 和 CD 中的发病率相似。医生和患者的看法不一致。这些症状应在门诊就诊时加以解决。
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来源期刊
United European Gastroenterology Journal
United European Gastroenterology Journal GASTROENTEROLOGY & HEPATOLOGY-
CiteScore
10.50
自引率
13.30%
发文量
147
期刊介绍: United European Gastroenterology Journal (UEG Journal) is the official Journal of the United European Gastroenterology (UEG), a professional non-profit organisation combining all the leading European societies concerned with digestive disease. UEG’s member societies represent over 22,000 specialists working across medicine, surgery, paediatrics, GI oncology and endoscopy, which makes UEG a unique platform for collaboration and the exchange of knowledge.
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