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Background <p>Although symptom severity has traditionally guided treatment decisions in inflammatory bowel disease (IBD), symptoms do not reliably reflect the degree of underlying intestinal inflammation. Mucosal healing has emerged as a critical treatment goal, owing to its strong association with improved long-term outcomes. Despite this paradigm shift, it is unclear how symptom severity influences clinicians’ decisions to assess for or pursue mucosal healing in routine practice.</p> Methods <p>We analyzed 5460 matched patient and provider surveys collected from June 2021 to October 2022 through the Crohn’s and Colitis Foundation’s national quality improvement program, IBD Qorus. Patient-reported symptoms, including stool frequency, rectal bleeding, abdominal pain and general sense of wellbeing, were evaluated in relation to provider-reported plans for endoscopy, fecal calprotectin testing, and treatment changes.</p> Results <p>Among patients reporting clinical remission, providers still planned endoscopy or stool biomarker testing within one year in over 60% of cases. Increased symptom severity—especially greater stool frequency, rectal bleeding, and worse general wellbeing—was significantly associated with earlier testing and treatment changes. Abdominal pain was not associated with these decisions. Providers expressed uncertainty regarding the timing of stool biomarker testing, particularly in patients with Crohn’s disease. Higher composite symptom scores were consistently associated with an increased likelihood of both testing and treatment adjustment.</p> Conclusion <p>Provider decisions to assess or treat for mucosal healing are associated with, but not fully driven by, symptom severity.</p>

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Understanding the Link Between Patient Symptoms and Provider Goals for Mucosal Healing in IBD: Insights from the IBD Qorus Survey

  • 期刊论文

  • 发表日期：

    2025年11月19日

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  • Angela Troia,
  • Sarah Harvey,
  • Angela Wu,
  • Sara Kiparizoska,
  • Alandra Weaver,
  • Ridhima Oberai,
  • Gil Y. Melmed,
  • Corey A. Siegel,
  • Siddharth Singh,
  • Mark C. Mattar

摘要

Background

Although symptom severity has traditionally guided treatment decisions in inflammatory bowel disease (IBD), symptoms do not reliably reflect the degree of underlying intestinal inflammation. Mucosal healing has emerged as a critical treatment goal, owing to its strong association with improved long-term outcomes. Despite this paradigm shift, it is unclear how symptom severity influences clinicians’ decisions to assess for or pursue mucosal healing in routine practice.

Methods

We analyzed 5460 matched patient and provider surveys collected from June 2021 to October 2022 through the Crohn’s and Colitis Foundation’s national quality improvement program, IBD Qorus. Patient-reported symptoms, including stool frequency, rectal bleeding, abdominal pain and general sense of wellbeing, were evaluated in relation to provider-reported plans for endoscopy, fecal calprotectin testing, and treatment changes.

Results

Among patients reporting clinical remission, providers still planned endoscopy or stool biomarker testing within one year in over 60% of cases. Increased symptom severity—especially greater stool frequency, rectal bleeding, and worse general wellbeing—was significantly associated with earlier testing and treatment changes. Abdominal pain was not associated with these decisions. Providers expressed uncertainty regarding the timing of stool biomarker testing, particularly in patients with Crohn’s disease. Higher composite symptom scores were consistently associated with an increased likelihood of both testing and treatment adjustment.

Conclusion

Provider decisions to assess or treat for mucosal healing are associated with, but not fully driven by, symptom severity.