Background: Cyclic vomiting syndrome (CVS) is a functional gastrointestinal disorder

F atigue is common and debilitating, reported by more than 80% of patients with active inflammatory bowel disease (IBD) and 40% with quiescent disease. 1,2 The etiology is complex and incompletely understood. Studies have suggested links between fatigue, IBD activity, and various psychological factors. [3][4][5][6] We assessed the relationship between fatigue and clinical and biochemical disease activity, as well as factors including mood, somatization, and the presence of irritable bowel syndrome (IBS)-type symptoms. We hypothesized that there would be no correlation between fatigue and objective markers of disease activity, rather than that fatigue would be associated with low mood, somatoform behavior, and symptom reporting in general.

Introduction:Fatigue is a frequent, debilitating symptom of inflammatory bowel disease (IBD). Despite this, studies report dissatisfaction among IBD patients regarding how little attention is given to fatigue-related issues during consultations. We performed a pilot randomized controlled trial (RCT) to assess whether a brief, structured, multidisciplinary psychological support program improved fatigue, mood and quality of life indices in patients with quiescent IBD.Methods:The intervention consisted of three small-group psychoeducational sessions over 6 months. Primary outcomes were effect on fatigue severity and impact scores. Secondary outcomes included effect on depression, anxiety, somatization scores, generic and disease-specific quality of life.Results:Twenty-three patients were enrolled, 10 in the intervention arm and 13 controls. Mean fatigue severity and impact scores improved for patients in the intervention group (by 14.5–13.1 and 49.7–45.8, respectively), and worsened in controls (by 11.5–12.6 and 33.5–35 respectively). Mean Short Form 36 (SF-36) scores for role limitations due to physical health decreased from 44.4 to 38.9 in the intervention group, but increased from 44.2 to 51.9 among controls. Energy scores in the intervention group improved from 17.8 to 26.6, but only from 31.4 to 31.7 among controls. Short IBD questionnaire scores improved in both groups, from 46.2 to 45.2 in controls compared with 44.4–40 in the intervention group.Discussion:In this small pilot RCT, positive effects were demonstrated on fatigue, energy levels and other quality of life outcomes. Larger, adequately powered studies with longer follow up are required.ClincialTrials.gov identifier: NCT02709434.