Fatigue in inflammatory bowel disease and its impact on daily activities

Publication

Fatigue in inflammatory bowel disease and its impact on daily activities

Journal Paper/Review - Nov 7, 2020

Schreiner Philipp, Misselwitz Benjamin, von Känel Roland, Rogler Gerhard, Juillerat Pascal, Pittet Valérie, Vavricka Stephan R, Scharl Michael, Greuter Thomas, Baumann Christian R, Valko Philipp O, Biedermann Luc, Rossel Jean-Benoit, Swiss IBD Cohort Study Group

Citation

Schreiner P, Misselwitz B, von Känel R, Rogler G, Juillerat P, Pittet V, Vavricka S, Scharl M, Greuter T, Baumann C, Valko P, Biedermann L, Rossel J, Swiss IBD Cohort Study Group. Fatigue in inflammatory bowel disease and its impact on daily activities. Aliment Pharmacol Ther 2020; 53:138-149.

Type

Journal Paper/Review (English)

Journal

Aliment Pharmacol Ther 2020; 53

Publication Date

Nov 7, 2020

Issn Electronic

1365-2036

Pages

138-149

Brief description/objective

BACKGROUND
Fatigue is a common symptom of chronic inflammation, including inflammatory bowel disease (IBD), resulting in significant impairment in quality of life.

AIMS
To identify the prevalence of fatigue in a large IBD cohort compared to the general population, address risk factors, and evaluate its impact on daily life.

METHODS
We evaluated 1208 IBD patients from the Swiss Inflammatory Bowel Disease Cohort Study (SIBDCS) and 414 healthy controls. Significant fatigue was defined as a visual analogue scale (VAS-F, range 0-10) score ≥ 4. Secondary endpoints were severity of fatigue and its impact on daily activities with the Fatigue Severity Scale (FSS), with a score ≥ 4 indicative of fatigue. Demographic, IBD-related and psychiatric symptoms were assessed with a multivariate analysis of variance (MANOVA) model optimised for prediction of VAS-F (primary outcome) and FSS scores.

RESULTS
Overall, 672 IBD patients (55.6%) reported significant fatigue compared to 145 (35%) controls (OR 2.71; 95% CI 2.08-3.54; P < 0.001). In IBD, fatigue also significantly affected daily activities (FSS ≥ 4; 405 (33.5%) IBD patients vs 81 (19.6%) controls, P < 0.001). In the MANOVA model, fatigue levels were associated with female gender (coefficient 0.839; 0.556 - 1.123; P < 0.001), younger age at diagnosis (-0.031 per year; -0.042- -0.019; P < 0.001), shorter disease duration (-0.036 per year; -0.050- -0.022; P < 0.001), nocturnal diarrhoea (0.718; 0.295-1.141; P = 0.001), low educational level (P = 0.034) and symptoms of depression and anxiety.

CONCLUSIONS
Fatigue is both more frequent and more severe in patients with IBD than in the general population.