P1046Faecal Urgency in Crohn’s Disease: Correlation with Disease Location, Activity, Psychobiological Factors and Poor Outcomes after 52 Weeks

Abstract Background Faecal urgency (FU) is a common yet often underrecognized symptom in patients Crohn’s disease (CD). In ulcerative colitis its presence is readily explained by distal colonic involvement, being less straightforward in CD1,2. This study aims to evaluate the presence of FU in patients with CD, and its associations with disease activity, psychobiological factors and clinical outcomes over a 52-week follow-up period. Methods A prospective study was carried out at a tertiary centre, including all CD patients who completed a questionnaire between July and September 2024, which included a FU Numeric Rating Scale, Work Productivity and Activity Impairment Questionnaire (WPAI-GH), Short Inflammatory Bowel Disease Questionnaire (SIBDQ), and Hospital Anxiety and Depression Scale (HADS). Patients were followed by 52 weeks to assess emergency room (ER) admissions, hospitalizations, need for corticosteroids, escalation of therapy, surgery and death. Data analysis was conducted using SPSS Statistics, version 26®. Results A total of 158 patients were included, with a mean age of 42.1±1.3 years; 88 (55.7%) were female. Among the participants, 109 (69.0%) reported experiencing FU, 69 of 97 (71.1%) patients with proximal and 40 of 61 (65.6%) with distal disease. Distal and rectal involvement was not associated with the presence or severity of FU. No significant correlation was found between the presence or severity of FU and markers of disease activity. In contrast, the severity of FU showed a positive correlation with elevated anxiety symptoms (ρ = 0.32; p 0.001), depressive symptoms (ρ = 0.31; p 0.001), overall work productivity loss (ρ = 0.42; p 0.001) and poorer QoL (ρ=- 0.52; p 0.001). After 52 weeks, higher severity of FU, but not anxiety or depressive symptoms, was associated with ER admissions (OR = 1.36 [1.09-1.71; p = 0.007]. Contrarily FU was not associated with other marks of disease severity, namely hospitalization, need for corticosteroid, escalation of therapy and surgery (OR = 1.11 0.96-1.29; p = 0.15). Additionally we didn’t find any correlation between FU and changes in biochemical activity (C reactive protein: ρ=-0.03; p = 0.68; faecal calprotectin: ρ = 0.02; p = 0.80). Conclusion These findings highlight FU as a clinically significant symptom in CD, which is not associated with anatomical location of lesions and inflammatory activity. It may be faced as functional disorder that warrants targeted management to reduce health-related costs. References: 1. Ha C, Naegeli AN, Lukanova R, Shan M, Wild R, Hennessy F, Jyothi Kommoju U, Potts Bleakman A, Hunter Gibble T. Rectal Urgency Among Patients With Ulcerative Colitis or Crohn’s Disease: Analyses from a Global Survey. Crohns Colitis 360. 2023 Sep 25;5(4):otad052. doi: 10.1093/crocol/otad052. PMID: 37928613; PMCID: PMC10622170. 2. Dawwas GK, Jajeh H, Shan M, Naegeli AN, Hunter T, Lewis JD. Prevalence and Factors Associated With Fecal Urgency Among Patients With Ulcerative Colitis and Crohn’s Disease in the Study of a Prospective Adult Research Cohort With Inflammatory Bowel Disease. Crohns Colitis 360. 2021 Jul 8;3(3):otab046. doi: 10.1093/crocol/otab046. PMID: 36776663; PMCID: PMC9902261. Conflict of interest: Dr. Borges Chaves, Carlos: No conflict of interest Azevedo Silva, Inês: None Feijó, Diogo: No conflict of interest Temido, Maria José: No conflict of interest Sant’Anna, Mariana: No conflict of interest Silva, Andrea: No conflict of interest Ferreira, Margarida: No conflict of interest Lopes, Sandra Maria Fernandes: No conflict of interest Mendes, Sofia: No conflict of interest Ferreira, Manuela: No conflict of interest Figueiredo, Pedro: No conflict of interest Portela, Francisco: No conflict of interest