Abstract
Background: Although highly prevalent among inflammatory bowel disease (IBD) patients, fatigue remains an unmet clinical need. The aim was to describe the prevalence of fatigue in an IBD population in remission and identify factors associated with fatigue. Methods: IBD patients in clinical and biochemical remission under treatment with immunomodulators or biologicals were included. Fatigue, physical tiredness and depression were assessed using the fatigue Visual Analogue Scale (fVAS), the Shortened Fatigue Questionnaire (SFQ) and the Quick Inventory of Depressive Symptomatology-Self Report (QIDS-SR), respectively. Relevant clinical and biochemical parameters were included in regression analyses to identify factors associated with physical fatigue. Results: In total, 157 IBD patients were included. Up to 45.9% of patients reported fatigue, physical tiredness was observed in 51% and depression in 10.8%. The majority of patients with subclinical depression were fatigued. Female sex (OR = 4.17 [1.55–6.78], p = 0.002) was independently associated with physical fatigue. Transferrin saturation (OR = −0.11 [−0.22–−0.007], p = 0.037) and treatment with adalimumab (compared to infliximab, OR = −3.65 [−7.21–−0.08], p = 0.045) entailed a lower risk of fatigue. Conclusion: Fatigue is observed in about half of IBD patients in remission and can be a symptom of underlying undetected depression. Sex, transferrin saturation and medication were identified as independent risk factors.
Highlights
Inflammatory bowel diseases (IBDs) are chronic inflammatory conditions of the gastrointestinal tract
The quality of life (QoL) in IBD patients is determined by more than gastrointestinal symptoms alone; disabling fatigue is often reported by patients as one of the most burdensome symptoms, especially during disease remission, when gastrointestinal symptoms are less dominant over daily life [4,5,6,7,8]
The study population consisted of adult IBD patients, either Crohn’s disease (CD) or ulcerative colitis (UC), followed at a single tertiary referral hospital
Summary
Inflammatory bowel diseases (IBDs) are chronic inflammatory conditions of the gastrointestinal tract. The estimated prevalence of fatigue is 72% during active intestinal inflammation and 47% during remission [9]. Another frequently neglected health problem in IBD is depression. Highly prevalent among inflammatory bowel disease (IBD) patients, fatigue remains an unmet clinical need. Methods: IBD patients in clinical and biochemical remission under treatment with immunomodulators or biologicals were included. Relevant clinical and biochemical parameters were included in regression analyses to identify factors associated with physical fatigue. Up to 45.9% of patients reported fatigue, physical tiredness was observed in 51% and depression in 10.8%. Conclusion: Fatigue is observed in about half of IBD patients in remission and can be a symptom of underlying undetected depression. Transferrin saturation and medication were identified as independent risk factors
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