Bowel urgency is much more common during a UC flare, but people with inflammatory bowel disease (IBD) may also experience urgency while in remission.

Bowel urgency is the sudden and unexpected need to have a bowel movement. Stool frequency and diarrhea can increase bowel urgency. Urgency is associated with bowel incontinence (having an accident).

It’s one of the most common symptoms in UC, with more than 80%Trusted Source of people with UC experiencing it. Up to 50% experience this symptom on a daily basis. This can have a huge impact on a person’s life.

People living with bowel urgency consistently rank it as a top concernTrusted Source. But there’s a disconnect in how healthcare professionals view this symptom.

Healthcare professionals often monitor other symptoms, such as blood in the stool or diarrhea, to assess whether a treatment works.

According to the Communicating Needs and Features of IBD Experiences (CONFIDE) studyTrusted Source published in 2023, healthcare professionals must give more attention to bowel urgency.

Bowel urgency is not fully understood. The ongoing inflammation during a flare-up of UC causes changes to the large intestine and rectum.

The rectum can become more sensitive, which can trigger the sudden need for a bowel movement.

Damage from inflammation can cause a buildup of scar tissue through the large intestine and rectum, which changes how the bowel functions. Diarrhea and stool frequency are common during a flare, which can worsen bowel urgency.

A 2020 research reviewTrusted Source of 3,169 people with IBD in remission found that 28.7% of people with UC also experience symptoms of inflammatory bowel syndrome (IBS).

People with IBS may continue to experience diarrhea and urgency even when their UC is in remission.

Bowel urgency can affect your physical and mental health and your social life.

In a surveyTrusted Source of 501 people with UC, participants were asked which symptom they most wanted to improve. Bowel urgency was the top answer, with 62.5% of survey respondents choosing this symptom.

In the same survey, 30% of people were hesitant to discuss bowel urgency with their healthcare professional. That means many people aren’t getting the care they need and deserve.

ResearchTrusted Source suggests that improvements in bowel urgency should be used more often as a measure of remission. People may still experience urgency even as symptoms such as frequency and bloody stools get better.

Even when other symptoms improve, bowel urgency is associatedTrusted Source with an increased risk of hospitalization and surgery.

The mental health and social impacts of bowel urgency are significant. In a 2022 survey of 200 people with IBD, 37% had avoided school or work in the past 3 months due to bowel urgency.

Living with UC can increase the riskTrusted Source of isolation, anxiety, and depression.

Getting inflammation under control is the most important step in managing urgency. Treatments that ease the inflammation of a UC flare will typically also improve bowel urgency.

Medications that can help to improve bowel urgency include:

  • Upadacitinib (Rinvoq): This is a Janus kinase (JAK) inhibitor that targets specific immune proteins. It has been shownTrusted Source to improve bowel urgency and induce remission.
  • Mirikuzimab (Omvoh): This is a type of monoclonal antibody. A 2023 studyTrusted Source compared mirikuzimab to placebo. Mirikuzimab improved bowel urgency and induced remission in a significant number of participants by week 12 and again at week 52.
  • Loperamide (Imodium, others): This medication treats diarrhea and may be especially helpful for people with co-occurring IBS.
  • Tricyclic antidepressants such as amitriptyline, nortriptyline, and desipramine: These medications may be helpful for people who are experiencing bowel urgency after UC is in remission.

The following approaches may also help manage bowel urgency:

  • Pelvic floor exercises: Strengthening the muscles in your pelvic floor may be helpfulTrusted Source as part of managing urgency. Consider working with a pelvic floor therapist.
  • Lower caffeine intake: Caffeine is a stimulant and can increaseTrusted Source urgency and diarrhea. Try drinking less coffee and caffeinated drinks to see if this helps.
  • Low fiber/low-residue diet: This eating pattern limits high fiber foods. This may helpTrusted Source to slow down digestion and reduce urgency. It’s usually intended to be short-term until symptoms subside.
  • Low FODMAP diet: There’s some evidenceTrusted Source that a low FODMAP diet can help to reduce diarrhea, urgency, and incontinence. This diet limits carbohydrates that may cause digestive symptoms in those with IBS.
  • Keep a food and symptom journal: Make notes about your food intake, urgency, and any other symptoms. You might start to see some patterns.

If you’re still experiencing bowel urgency despite being in remission, make sure to discuss this with your healthcare professional.

Talk with your healthcare professional about other ways to manage bowel urgency, even if your other symptoms improve. Ongoing bowel urgency can affect your quality of life.

If your healthcare professional doesn’t ask you about your bowel urgency, be sure to let them know. You deserve to feel better and get this symptom under control.