Bowel Urgency Is More Strongly Associated with Biochemical, Endoscopic, and Histological Disease Activity than Other Clinical Symptoms in Ulcerative Colitis
Abstract
Objective Bowel urgency (BU) is one of the most common and distressing symptoms of ulcerative colitis (UC). However, its relationship with the disease activity has not yet been fully elucidated. We aimed to evaluate the clinical significance of BU as an indicator of the disease activity in comparison with other clinical symptoms of UC.Methods We conducted a retrospective observational study of patients with UC who underwent colonoscopy at our institution. Correlation analyses were performed between symptomatic subscores, including BU, stool frequency, rectal bleeding, and physician's global assessment, and the disease activity indices. The BU subscore was assessed using the BU item of the Simple Clinical Colitis Activity Index (SCCAI) without modification, as follows: 0, no BU; 1, acute BU; 2, immediate BU; and 3, stool incontinence. In addition, the clinical disease activity (Mayo and partial Mayo scores), biochemical markers, endoscopic activity (Mayo Endoscopic Subscore [MES] and Ulcerative Colitis Endoscopic Index of Severity [UCEIS]), and histological activity (Matts' histological grade) were compared between patients with and without BU.Results Among 62 patients, 29.0% had BU. BU subscores showed stronger correlations with leucine-rich alpha-2 glycoprotein (LRG), MES, UCEIS, and Matts' histological grade than with the other symptomatic subscores. The Mayo and partial Mayo scores, MES, UCEIS, and Matts' histological grades were also significantly higher in the BU-present group, and all indices showed significant stepwise increases with higher BU subscores. Biochemical markers showed a similar pattern; patients with BU had higher LRG levels and white blood cell counts and lower hemoglobin and albumin levels than those with non-BU.Conclusion BU is more strongly associated with the biochemical, endoscopic, and histological disease activity than other clinical symptoms in UC, suggesting that it may serve as a clinically meaningful indicator for disease assessment in UC.
Related
- Deep learning-based assessment of ulcerative colitis activity from full-length endoscopic videos with spatial characterisation and histological correlation
- Pitfalls and challenges in endoscopic assessment of ulcerative colitis.
- Bilirubin statistically accounts for the association between Enterobacterales lineage and Mayo endoscopic score in ulcerative colitis: a cross-sectional associational variable analysis.
- Automated assessment of the ulcerative colitis endoscopic index of severity using a multi-task deep learning model
- Diagnostic prediction of ulcerative colitis using simplified endoscopic features and blood count-derived indices: a multicenter study
BibTeX
@article{ogihara2026bowel,
title = {{Bowel Urgency Is More Strongly Associated with Biochemical, Endoscopic, and Histological Disease Activity than Other Clinical Symptoms in Ulcerative Colitis}},
author = {Ryohei Ogihara and Hiroki Kurumi and Koichiro Kawaguchi and Kazuo Yashima and Hajime Isomoto},
journal = {Internal Medicine},
year = {2026},
month = sep,
doi = {10.2169/internalmedicine.6811-25},
url = {https://www.jstage.jst.go.jp/article/internalmedicine/advpub/0/advpub_6811-25/_article},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Bowel Urgency Is More Strongly Associated with Biochemical, Endoscopic, and Histological Disease Activity than Other Clinical Symptoms in Ulcerative Colitis
AU - Ryohei Ogihara
AU - Hiroki Kurumi
AU - Koichiro Kawaguchi
AU - Kazuo Yashima
AU - Hajime Isomoto
PY - 2026
DA - 2026/09/22
JO - Internal Medicine
DO - 10.2169/internalmedicine.6811-25
UR - https://www.jstage.jst.go.jp/article/internalmedicine/advpub/0/advpub_6811-25/_article
AB - Objective Bowel urgency (BU) is one of the most common and distressing symptoms of ulcerative colitis (UC). However, its relationship with the disease activity has not yet been fully elucidated. We aimed to evaluate the clinical significance of BU as an indicator of the disease activity in comparison with other clinical symptoms of UC.Methods We conducted a retrospective observational study of patients with UC who underwent colonoscopy at our institution. Correlation analyses were performed between symptomatic subscores, including BU, stool frequency, rectal bleeding, and physician's global assessment, and the disease activity indices. The BU subscore was assessed using the BU item of the Simple Clinical Colitis Activity Index (SCCAI) without modification, as follows: 0, no BU; 1, acute BU; 2, immediate BU; and 3, stool incontinence. In addition, the clinical disease activity (Mayo and partial Mayo scores), biochemical markers, endoscopic activity (Mayo Endoscopic Subscore [MES] and Ulcerative Colitis Endoscopic Index of Severity [UCEIS]), and histological activity (Matts' histological grade) were compared between patients with and without BU.Results Among 62 patients, 29.0% had BU. BU subscores showed stronger correlations with leucine-rich alpha-2 glycoprotein (LRG), MES, UCEIS, and Matts' histological grade than with the other symptomatic subscores. The Mayo and partial Mayo scores, MES, UCEIS, and Matts' histological grades were also significantly higher in the BU-present group, and all indices showed significant stepwise increases with higher BU subscores. Biochemical markers showed a similar pattern; patients with BU had higher LRG levels and white blood cell counts and lower hemoglobin and albumin levels than those with non-BU.Conclusion BU is more strongly associated with the biochemical, endoscopic, and histological disease activity than other clinical symptoms in UC, suggesting that it may serve as a clinically meaningful indicator for disease assessment in UC.
SN - 1349-7235
SN - 0918-2918
ER -