Fatigue in inflammatory bowel disease: understanding research needs through an exploratory narrative review

Shellie Jean Radford

doi:10.12968/gasn.2019.17.4.30

Abstract

Aims: To summarise the main findings from research on current understanding of fatigue in inflammatory bowel disease (IBD). Methods: A narrative review of relevant literature corresponding to IBD fatigue was conducted. Results: IBD fatigue is multidimensional and has a complex aetiology. The subjective nature and the lack of a standardised measure of fatigue add to the challenge of developing suitable and effective management methods. Although IBD fatigue is highlighted as a top-five priority research area by N-ECCO, it remains a complex and relatively unexplored area, especially when considering health-related quality of life (HRQoL) and patient experience. Conclusions: Research on the pathogenesis of IBD-related fatigue, effective measurement and its impact on IBD patients will allow the discovery of predictors of severe fatigue that requires clinical intervention, as well as the development of clear treatment pathways and structured support for IBD patients.

Highlights

Patients with Inflammatory Bowel Disease (IBD) are affected by a number of symptoms, undergo lifelong pharmacological treatments and clinical interventions. (Bennebroek Evertsz’ et al, 2012; O’Connor et al, 2013) Fatigue is one of the most experienced symptoms of patients with IBD, and has some of the largest impact on patients’ lives.(Czuber-Dochan, Ream and Norton, 2013) IBD related fatigue is only identified in a relatively small proportion of those affected. (Van Langenberg and Gibson, 2014; Williet et al, 2017)
The complex aetiology of IBD fatigue, its subjective nature and the lack of a standardised measure of fatigue add to the challenge of developing suitable and effective management methods. (Simrén et al, 2008; Whitehead, 2009; Czuber-Dochan, Ream and Norton, 2013) IBD usually has an early onset and is a chronic, incurable, condition
Fatigue is often attributed to long-term conditions (LTC) conditions, it is experienced by most people at some point in life and can usually be allied to excessive physical activity, stress or ill health.(Wu, Wyrwich and McSweeney, 2006) Fatigue is often the first symptom reported in acute physical or mental illness,(Minden, Orav and Reich, 1987; Dittner, Wessely and Brown, 2004; Radbruch et al, 2008) often preceding and following the period of illness.(Vollmer-Conna et al, 2004; Wu, Wyrwich and McSweeney, 2006) In LTC, fatigue can lead to a chronic psychological depletion of energy reserves and result in functional impairment (RombergCamps et al, 2010), this type of fatigue which arises from a pathological process or psychological disorder of a longer duration is often referred to as chronic fatigue

Summary

Introduction

Patients with Inflammatory Bowel Disease (IBD) are affected by a number of symptoms, undergo lifelong pharmacological treatments and clinical interventions. (Bennebroek Evertsz’ et al, 2012; O’Connor et al, 2013) Fatigue is one of the most experienced symptoms of patients with IBD, and has some of the largest impact on patients’ lives.(Czuber-Dochan, Ream and Norton, 2013) IBD related fatigue is only identified in a relatively small proportion of those affected. (Van Langenberg and Gibson, 2014; Williet et al, 2017).

Results

Conclusion