One of the hallmark symptoms of ulcerative colitis (UC) is urgency, the uncomfortable sensation of having to defecate immediately. Urgency might significantly impair a person's ability to travel, attend events, and leave the house without the knowledge of where the closest bathroom is. In this study, researchers evaluated the relationship between urgency and quality of life and other outcomes, like hospitalizations and surgery.

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Urgency, which is the immediate need to defecate, is common in IBD. In this study, we evaluated the relationship between urgency in ulcerative colitis patients and outcomes like quality of life and hospitalizations.

We studied 632 patients with UC. Urgency, described as "hurry," "immediately," and "incontinence," was associated with many factors like social isolation, depression, anxiety, and fatigue. It was also associated with increased risk of hospitalization, steroids, and surgery.

These findings support using urgency as an important quality of life outcome to be studied in clinical trials.

Between 2011 and 2018, participation in randomized controlled trials (RCTs) for inflammatory bowel disease declined while available RCTs in-creased. Younger patients, patients in community settings, and patients with milder disease were underrepresented in RCTs. Nonparticipants had disease activity failing remission criteria, highlighting the role of RCT participation.

Studies suggest that there is a temporal relationship between depression and Crohn's disease (CD) activity. We evaluated the existence of reverse causality reflected in a possible bidirectional relationship between patient-reported CD activity and depression. To research this, we studied 3307 adult volunteers with a self-reported diagnosis of CD who completed a baseline survey that included demographics, CD activity, and depression. Crohn's disease status and depression were also measured 6 and 12 months after the first evaluation. The results of the hypothesis testing showed the most support for the hypothesis stating that depression is a stronger predictor of patient-reported CD activity. In conclusion, our findings suggest that CD patients' negative self-regard is clinically important to understanding change in patient reports of their CD activity. Gastroenterologists should screen for affective-cognitive symptoms of depression in CD patients. Evaluation and treatment of depression may improve the course of CD.

Research has shown that patients with chronic diseases have better health outcomes if they are knowledgeable, skilled and confident in managing their disease. In this study, researchers wanted to find out if this is true for patients with IBD. To evaluate this, they delivered a survey called the Patient Activation Measure to 1,486 patients with IBD. Based on this survey, patients are placed on one of four levels. The lowest level is Level 1, "disengaged and overwhelmed." The highest level is Level 4, "maintaining behaviors and pushing further." Follow-up data available for 1082 survey participants (73%) showed that patients with high activation (levels 3 or 4) were more likely than those with low activation (levels 1 or 2) to be in clinical remission 6-12 months after the initial survey assessment.

Little research has been done exploring how inflammatory bowel disease (IBD) affects sexual health. In this study, investigators asked a large group of IBD patients to complete a 6-question online survey. The questions asked about sexual interest and satisfaction. Researchers found that these IBD patients had similar levels of sexual interest as the general population, but they had lower sexual satisfaction and lower quality of life as it related to their IBD. Older age, disease activity, depression, anxiety, and pain were associated with these findings. Exploring these sexual health topics during clinical encounters can help improve IBD quality of life.

Symptoms (pain, fatigue, sleep disturbance, depression, and anxiety) are common among people with Inflammatory Bowel Disease (IBD). We know people do not experience only one symptom and symptoms may occur is clusters. Symptom clusters are two or more symptoms that occur together and are related. Understanding how symptoms cluster is needed so that we can develop methods that decrease multiple symptoms in IBD. The purpose of this study was to (a) describe how symptoms cluster in IBD, and (b) to describe the relationship between demographic and clinical factors and symptom cluster membership.

In this study, we used the CCFA Partners Cohort and the symptoms of pain interference, fatigue, sleep disturbance, anxiety, and depression. There were 5,296 participants with an average age of 44 years, and the sample was 72% female. We discovered four symptom cluster groups. The first group was labeled "low symptom burden" (26%), and this group had symptoms of pain, fatigue, sleep disturbance, depression, and anxiety. The second, and largest group (38%) was labeled "high symptom burden," and included pain, fatigue, sleep disturbance, depression, and anxiety. The third group included 22.09% of participants, was labeled "physical symptoms," and had the symptoms of pain, fatigue, and sleep disturbance. The fourth group "psychological symptoms," was the smallest group at 14.22%, and included the symptoms of anxiety and depression. Being female, having a history of smoking, currently taking corticosteroids, Crohn's disease, and active disease state were associated with belonging to the high symptom burden group compared to the low symptom burden group. Additional research is needed to test strategies that may be effective at reducing symptoms in people with IBD.

Patients with Crohn's disease, or CD, may require surgery during the course of their disease. This can result in the need to create a permanent or a temporary ostomy. Ostomy is the term used to describe the surgically created connection between the intestine and the abdominal wall. It allows for the evacuation of the fecal matter through the abdominal wall. The potential need for an ostomy is a major concern for many patients with inflammatory bowel disease as it may impact their daily function and quality of life. Within the CCFA Partners network, we evaluated the characteristics of CD patients who had an ostomy for at least 6 months. We also looked at how ostomy impacts their daily function and quality of life. A total of 4733 patients were included, of these, 402 reported an ostomy for at least 6 months. Patients with ostomy were more likely to be in clinical remission compared to those with no ostomy. Also, only half the patients with ostomy were receiving specific IBD therapies. Having an ostomy did not impact the quality of life or sexual function (interest and satisfaction) of CD patients. Additionally, there was no association between having an ostomy and anxiety, depression, or sleep disturbances. However, having an ostomy was associated with increased pain interference, fatigue and lower social satisfaction. It was also associated with higher rated of narcotic use. Appropriate counseling before and after surgery can help improving social satisfaction for patients with ostomy. Further studies are needed to determine the nature of pain and fatigue in this population.

Patients with celiac disease (an autoimmune disorder where eating gluten can damage the small intestine) benefit from a gluten free diet (GFD). Few data are available to tell us if patients with inflammatory bowel diseases (IBD) may also benefit from this diet. Individuals with GI symptoms such as bloating, abdominal pain, diarrhea, fatigue and nausea can have non-celiac gluten sensitivity, for which a GFD can be beneficial. Non-celiac gluten sensitivity can also co-exist with IBD. We therefore asked patients enrolled in CCFA Partners whether they have ever tried a gluten free diet (GFD), whether they followed this diet closely, and whether it helped with any symptoms. A total of 1647 people took the survey on GFD. A total of 314 (19.1%) reported that they had ever tried a GFD and 135 (8.1%) were currently following the diet. Overall, 206/314 (65.6%) trying a GFD reported improvement in any GI symptom while on this diet. Over a 1/3 of people (38.3%) felt that they experienced fewer or less severe flares while on the diet. Improvements in clinical symptoms were reported for bloating (56.5%), diarrhea (42.6%), abdominal pain (41.5%), fatigue (27.5%), and nausea (26.3%) while on a GFD. Fatigue was significantly improved with excellent adherence to the diet. Because many patients had improved symptoms on the GFD, it is possible that patients with IBD could suffer from non-celiac gluten sensitivity. Fewer people who felt better on a GFD were taking biologics medications, suggesting that flare symptoms in those with more severe disease may not respond to a GFD. Future studies are needed to understand the benefits of this diet in IBD patients, and the mechanism of improvement with this dietary intervention.