Abstract Background Bowel urgency is a highly bothersome, often underapprecaited symptom of Crohn’s disease (CD). The Urgency Numerical Rating Scale (U-NRS) quantifies the degree of fecal urgency experienced over the past 24 hours by patients on a 0-10 scale. We assumed that the scale has a large variance, as patients may interpret their own symptoms differently. The same score may reflect different quality for two patients. The score on the U-NRS may be influenced by the individual’s specific perception of symptoms (degree of pain, speed of urge). The objective of our study was to investigate the possible components of urgency in patients with CD. Methods Patients with CD aged ≥18 years treated at our departments for at least 3 months and having complaints were included in our study. The patients filled out our non-validated questionnaire assessing faecal urgency (U-NRS), pain level, speed of urge, incontinence and lifestyle factors related to incontinence. Statistical analysis was performed using STATA 18 program. Results 44 patients with median age 39 years, 14±8.9 years mean disease duration were enrolled. The mean U-NRS score was 2±2.5, 48% (n = 21) of the patients had 0 score and only 1 patient had 10 score. 1 patient felt most difficult to hold mucus, 43% (n = 19) stool and 14% (n = 6) other secretions. 2% (n = 1) had urge with every stool in the last 24 hours, 44% (n = 20) had less than half of defecations. 27% (n = 12) could hold the faeces in the last 7 days less than a minute. 16% (n = 7) used diapers. The correlation between U-NRS and the level of pain of defecation was weak (R2=0.13) which was weaker than in patients with ulcerative colitis that we examined in another study. Patient reported outcome (PRO2) had a weak correlation with U-NRS (R2=0.23). The level of urgency, duration of faeces holding (R2=0.35) and the frequency of faeces holding problems (R2=0.52) had the strongest correlation with U-NRS. Patients defined urgency with these parameters according to these results. We created a new score with these parameters, level of urgency points + half of duration points + frequency, which showed a good model to refine the definition of urgency, the correlation with U-NRS was high (R2=0.77) (Figure 1). Conclusion Bowel urgency has a great impact on the daily lives of patients with CD and is associated with more severe disability. Faecal urgency may be more accurately characterised by incorporating multiple dimensions—such as the intensity of the urge, duration of faeces holding, and stool frequency—rather than relying solely on a single subjective numerical scale. A new, multidimensional scoring system that captures more accurately patients’ complaints with urgency and allows for a more objective assessment of symptom severity is needed. Conflict of interest: Dr. Ivány, Emese: No conflict of interest Resál, Tamás: No conflict of interest Bacsur, Péter: No conflict of interest Barbara, Horvát: No conflict of interest Sarlós, Patrícia: No conflict of interest Palatka, Károly: No conflict of interest Ilias, Akos: No conflict of interest Bálint, Anita: No conflict of interest Farkas, Bernadett: No conflict of interest Rutka, Mariann: No conflict of interest Farkas, Klaudia: No conflict of interest Fábián, Anna: No conflict of interest Zsófia, Bősze: No conflict of interest Szepes, Zoltán: No conflict of interest Molnár, Tamás: No conflict of interest
Ivány et al. (Thu,) studied this question.