Bowel Urgency Remains an Underrecognized but High-Burden Symptom in Crohn’s Disease
Bowel urgency (BU) is highly prevalent among patients with Crohn’s disease (CD) but remains underrecognized in clinical practice and underrepresented in disease assessment tools, according to a recent narrative review examining its prevalence, impact, and management.
While bowel urgency has gained recognition as an important symptom in ulcerative colitis, the review notes that its significance in CD has received comparatively less attention. Reported in “up to 96% of patients with CD,” bowel urgency can substantially affect daily functioning and quality of life.
The authors describe BU as a multidimensional symptom associated with anxiety, social avoidance, and reduced participation in everyday activities. Despite this burden, bowel urgency is not included in many commonly used CD disease activity indices and is infrequently incorporated into clinical trial endpoints.
According to the authors, “an important challenge in the management of CD is the differing perceptions between patients and HCPs regarding the impact and importance of BU.” This gap may contribute to undertreatment and unmet patient needs.
The review summarizes evidence regarding the prevalence and clinical significance of bowel urgency while also exploring potential underlying mechanisms. In addition, the authors evaluated currently available assessment tools and therapeutic approaches used to address the symptom.
The findings suggest that bowel urgency extends beyond a simple gastrointestinal complaint and may represent a meaningful marker of disease burden that is insufficiently captured during routine care. The authors argue that current approaches may fail to adequately reflect patient experiences, particularly when symptom assessment focuses primarily on traditional disease activity measures.
The review concludes that “greater awareness and systematic evaluation of BU as a multidimensional symptom of CD are critical for optimizing care and aligning clinical management with patient priorities.” As research continues, incorporation of bowel urgency into clinical assessments and therapeutic decision-making may help address an important gap in Crohn’s disease management.
Reference
Dubinsky M, Bleakman AP, Vavricka S, et al. Bowel urgency in Crohn's disease: Bridging the gap between patients and healthcare providers. Am J Gastroenterology. 2026;121(5):p 1082-1093. | DOI: 10.14309/ajg.0000000000003858
