Fatigue Linked to Higher Levels of IBD Disease

Miguel Regueiro, MD

Fatigue is a common condition for patients with inflammatory bowel disease (IBD), but there are various trends that show whether a Crohn’s disease or ulcerative colitis patient is at a higher risk for fatigue.

A team, led by Miguel Regueiro, MD, Cleveland Clinic, assessed the prevalence of fatigue for Crohn’s disease and ulcerative colitis patients and evaluated the association of fatigue with disease activity and patient-reported outcomes.

The data was presented during the 2021 Digestive Disease Week (DDW) Virtual Meeting.

The Study

In the study, the researchers used data from a cross-sectional survey of gastroenterologists and their consulting adult Crohn’s disease (n = 1228) and ulcerative colitis (n = 1057) patients in France, Germany, Italy, Spain, the UK, and the US between 2017-2018. The data was collected through gastroenterologist-completed patient record forms and patient-self completed forms.

The gastroenterologist reported on patient demographics, clinical characteristics, disease activity, and medication use, while patients self-reported current symptoms, including fatigue, rectal urgency, abdominal pain, and sleep disturbance, work productivity, and the Short Inflammatory Bowel Disease Questionnaire (SIBDQ).

The researchers also conducted the analysis on Crohn’s disease and ulcerative colitis patients separately and compared demographics, clinical characteristics, disease activity, symptoms, and patient-reported outcomes between patients with fatigue and patients without fatigue using parametric tests and non-parametric tests.

Fatigue

Overall, fatigue was reported in 26% (n = 320) of Crohn’s disease patients and 22.6% (n = 239) of ulcerative colitis.

Some of the demographic trends found include that Crohn’s disease patients with fatigue are more likely to be female (P = 0.0193), unemployed (P = 0.0069), have moderate or severe disease (P <0.0001), and have a higher mean CDAI score (P <0.0001) compared to Crohn’s disease patients not suffering from fatigue.

For ulcerative colitis patients, individuals with fatigue were more likely to be unemployed (P = 0.0149), have moderate or severe disease (P = 0.0001), and have a higher Mayo score (P <0.0001) compared to ulcerative colitis patients without fatigue.

Fatigued patients with either inflammatory bowel disease were more likely to have rectal urgency, abdominal pain, a higher mean level of pain, and a higher mean level of sleep disturbance than patients without fatigue (all P <0.001) and lower SIBDQ scores (P <0.0001) and more work impairment (CD: P = 0.0015; UC: P = 0.0170) than patients without fatigue.

For treatment, both Crohn’s disease and ulcerative colitis patients with fatigue were more likely to receive corticosteroids (CD: P = 0.0008; UC: P = 0.0051) and biologics (CD: P <0.0001; UC: P = 0.0084) than patients without fatigue.

“Fatigue is a common symptom among CD and UC patients and is associated with higher levels of disease activity, decreased work productivity, and worse quality of life,” the authors wrote..

The study, “BURDEN OF FATIGUE AMONG CROHN'S DISEASE AND ULCERATIVE COLITIS PATIENTS: ANALYSES FROM A GLOBAL SURVEY OF PATIENTS AND GASTROENTEROLOGISTS,” was published online by DDW.