Abstract
BackgroundSimilarities in the symptoms of chronic fatigue syndrome (CFS) and inflammatory bowel disease (IBD) have been observed as follows: severe disease activity in IBD correlates with severe fatigue, major psychiatric signs, the common use of medication, and bacterial translocation. One of several hypotheses for explaining the mechanisms underlying CFS suggests a similarity to the impaired intestinal mucosa of IBD. “This study investigated the risk of incident CFS among patients with IBD”.MethodsWe conducted a population-based retrospective cohort study by using Taiwan’s National Health Insurance Research Database to evaluate the subsequent risk of CFS in patients with IBD, according to demographic characteristics and comorbidities. The exposure cohort comprised 2163 patients with new diagnoses of IBD. Each patient was randomly selected and frequency matching according to gender and age with four participants from the general population who had no history of CFS at the index date (control cohort). Cox proportional hazards regression analysis was conducted to estimate the relationship between IBD and the subsequent risk of CFS.ResultsThe exposure cohort had a significantly higher overall risk of subsequent CFS than that of the control group [adjusted hazard ratio (Christophi in Inflamm Bowel Dis 18(12):2342–2356, 2012) = 2.25, 95%, confidence interval (Aaron and Buchwald in Ann Intern Med 134(9 Pt 2):868–881, 2001; Farraye et al. in Am J Gastroenterol 112:241, 2017) 1.70–2.99]. Further analysis indicated a significantly higher risk of CFS in patients who were male (HR = 3.23, 95% CI 2.12–4.91), were older than 35 years, and had IBD but without comorbidity status, e.g. Cancers, diabetes, obesity, depression, anxiety, sleep disorder, renal disease (HR = 2.50, 95% CI 1.63–3.84) after adjustment.ConclusionThe findings from this population-based retrospective cohort study suggest that IBD, especially Crohn’s disease, is associated with an increased risk of subsequent CFS.
Highlights
Similarities in the symptoms of chronic fatigue syndrome (CFS) and inflammatory bowel disease (IBD) have been observed as follows: severe disease activity in IBD correlates with severe fatigue, major psychiatric signs, the common use of medication, and bacterial translocation
After adjustment for age, and comorbidities, the risk of Chronic fatigue syndrome (CFS) was higher in the IBD group than in the non-IBD group
The sex-specific analysis revealed that the incidence density rates of CFS in the women and men with IBD were 5.14 and 7.09 per 1000 person-years, respectively, which were higher than those in the women and men without IBD (2.83 and 1.90 per 1000 person-years, respectively)
Summary
Similarities in the symptoms of chronic fatigue syndrome (CFS) and inflammatory bowel disease (IBD) have been observed as follows: severe disease activity in IBD correlates with severe fatigue, major psychiatric signs, the common use of medication, and bacterial translocation. Chronic fatigue syndrome (CFS), called myalgic encephalomyelitis, is fatigue. This is a cluster of clinical symptoms which is defined as the presence of unexplainable fatigue lasting more than 6 months and accompanied by four or more of the following symptoms: substantial impairment in short-term memory, tender lymph nodes, sore throat, muscle pain, multiple joint pain without swelling or redness, headache, unrefreshing sleep, and postexertional malaise lasting more than 24 h [1]. Identifying the potential CFS population is crucial for early intervention
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