To the Editors:
We would like to thank Chen et al. for their interest in our study on fecal urgency and incontinence in patients with inflammatory bowel disease (IBD) [1]. We agree with the authors that the psychological and social impacts of these symptoms are considerable [2]. In this context, it is worrying that patients feel uncomfortable talking about them with their peers and doctors. Even more alarming—however—is the fact that a non‐negligible proportion of patients would like to discuss these issues more, but apparently were not inquired about them. It is known from other studies that these symptoms, which are unfortunately still far too tabooed, are associated with embarrassment, dietary limitations and even depression [3].
Our study primarily aimed to obtain an overview of the frequency of fecal urgency and incontinence with regard to IBD subtype and disease activity, their impact on disease severity and perception, and their importance during physician‐patient‐encounters. Their impact on psychological and social wellbeing was not discussed in our analysis. However, a re‐analysis of our data revealed that patients do not feel comfortable talking about fecal urgency with peers (31%) and physicians (5%), while these proportions are 39% (with peers) and 6% (with doctors) for fecal incontinence. Inclusion of psychological and social aspects would have been of interest, but they were not captured by our survey [1].
We support the suggestion of Chen and colleagues to explore the psychological and social impact of IBD symptoms in order to support patients in the best possible way. The authors correctly highlight the importance of psychological interventions such as counseling, cognitive behavioral therapy, and involvement in patient support groups. The management of IBD patients is so much more than just controlling intestinal inflammation.
Conflicts of Interest
The authors declare no conflicts of interest.
Data Availability Statement
The authors have nothing to report.
References
- 1. Wespi N., Vavricka S., Brand S., et al., “Fecal Urgency and Incontinence in Inflammatory Bowel Disease Perceived by Physician and Patient: Results From the Swiss Fecal Urgency Survey,” United European Gastroenterology Journal (September 2024): Epub ahead of print. PMID: 39246002, 10.1002/ueg2.12657. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 2. Chen X., Wang W., and Lv J., “Addressing the Overlooked Psychological and Social Impact of Fecal Incontinence in Inflammatory Bowel Disease Patients,” United European Gastroenterology Journal 12 (October 2024): Epub ahead of print. PMID: 39394886, 10.1002/ueg2.12687. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 3. Newton L., Randall J. A., Hunter T., et al., “A Qualitative Study Exploring the Health‐Related Quality of Life and Symptomatic Experiences of Adults and Adolescents With Ulcerative Colitis,” J Patient Rep Outcomes 3, no. 1 (2019): 66, 10.1186/s41687-019-0154-x. [DOI] [PMC free article] [PubMed] [Google Scholar]
Associated Data
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Data Availability Statement
The authors have nothing to report.