Abstract
Bowel urgency (BU) is a prevalent and highly burdensome symptom among patients with inflammatory bowel disease. While BU is now recognized as a key symptom of ulcerative colitis, in the case of Crohn's disease (CD), it is often under-recognized by healthcare providers (HCPs) and inadequately captured in clinical assessments. Reported in up to 96% of patients with CD, BU can significantly impair quality of life, contributing to anxiety, social withdrawal, and reduced daily functioning. Despite its frequency and impact, BU is excluded from widely used CD activity indices and is infrequently included in clinical trial end points. An important challenge in the management of CD is the differing perceptions between patients and HCPs regarding the impact and importance of BU. This disconnect between patients and HCPs may lead to gaps in treatment and unmet patient needs. This narrative review synthesizes recent evidence on the prevalence, clinical significance, and underlying mechanisms of BU in CD. We also examine its impact on quality of life, evaluate current assessment tools, and highlight therapeutic approaches and gaps in HCP-patient communication. 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.