Conventional treatment regimens for ulcerative colitis alleviate fatigue – an observational cohort study

Grimstad, Tore; Norheim, Katrine Brække; Kvaløy, Jan Terje; Isaksen, Kjetil; Leitao, Kristian; Carlsen, Arne; Karlsen, Lars Normann; Aabakken, Lars; Omdal, Roald

doi:10.1080/00365521.2016.1195869

Cited by 10 publications

(8 citation statements)

References 30 publications

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“…Some benefits have been shown by pharmacological interventions utilising biologics [39–41], thiamine [38] and ferumoxytol [42]. However, it is unclear whether these results were due to a direct effect on fatigue or a reduction in inflammation in patients with active disease [43]. The only trial [37] examining the effect of physical activity, provided inconclusive results.…”

Section: Introductionmentioning

confidence: 99%

Cognitive-behavioural therapy for the management of inflammatory bowel disease-fatigue: a feasibility randomised controlled trial

Artom

Czuber‐Dochan

Sturt

et al. 2019

Pilot Feasibility Stud

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BackgroundFatigue is the third most prevalent symptom for patients with inflammatory bowel disease (IBD), yet optimal strategies for its management are unclear. Treatment protocols for fatigue in other conditions have been based on cognitive-behavioural models. Targeting cognitions, emotions and behaviour related to fatigue through cognitive-behavioural therapy (CBT) may be a viable option to improve fatigue and quality of life (QoL) in IBD.MethodsThis single centre, two-arm, feasibility randomised controlled trial (RCT) aimed to assess the feasibility and initial estimates of potential efficacy of a CBT intervention for the management of IBD-fatigue. Feasibility, acceptability and initial estimates of potential efficacy outcomes were collected through self-report measures and semi-structured interviews. Participants were recruited from one tertiary referral centre. Intervention Group 1 received a CBT manual for fatigue, one 60-min and seven 30-min telephone sessions with a therapist over 8-weeks. Control Group 2 received a fatigue information sheet without therapist support. A nested qualitative study evaluated patients’ and therapists’ experiences, and IBD-healthcare professionals’ (HCPs) perceptions of the intervention.ResultsEighty-nine participants were assessed for eligibility. Of these, 31 of the 70 eligible participants consented to participate (recruitment rate of 44%). Of the 15 participants randomised to the intervention group, 13 (87%) started it and 10 (77% of those who started) completed all 8 sessions. Follow-up questionnaires were completed by 22 (71%) participants at 3 months, 14 (45%) at 6 months and 12 (39%) at 12 months’ follow-up. The intervention was acceptable to participants and feasible for therapists to deliver. HCPs reported that the intervention would be applicable, but time, finance and training constraints limit its implementation. Initial estimates of potential efficacy with complete case analysis showed a reduction in fatigue and an increase in QoL at 3, 6 and 12 months post-randomisation.ConclusionsA full-scale effectiveness RCT testing CBT for IBD-fatigue is feasible and is potentially worthwhile with some changes to the protocol. However, given the small numbers, further pilot work is warranted before a full-scale RCT.Trial registrationRegistration Trial ISRCTN 17917944, Registered 2 September 2016

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Section: Introductionmentioning

confidence: 99%

Cognitive-behavioural therapy for the management of inflammatory bowel disease-fatigue: a feasibility randomised controlled trial

Artom

Czuber‐Dochan

Sturt

et al. 2019

Pilot Feasibility Stud

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“…234 Anti-TNF treatment at baseline was linked to more severe fatigue perception, 235 and the cessation of biological therapies was associated with reduced fatigue perception. 13 In contrast, 12 weeks of conventional therapy consisting of 5-aminosalicylates, corticosteroids and/or thiopurine reduced fatigue perception in a cohort of 82 newly diagnosed UC patients, 236 whilst infliximab 14 and adalimumab 21 treatments have also reduced fatigue perception. The contrasting data linking such therapies to increased fatigue perception 13,235 suggest disease activity is a confounding factor rather than any specific drug-related effect.…”

Section: Treatment-related Factorsmentioning

confidence: 99%

Review article: The aetiology of fatigue in inflammatory bowel disease and potential therapeutic management strategies

McGing

Radford

Francis

et al. 2021

Aliment Pharmacol Ther

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Background: Fatigue is the inability to achieve or maintain an expected work output resulting from central or peripheral mechanisms. The prevalence of inflammatory bowel disease (IBD) fatigue can reach 86% in active disease, persisting in 50%-52% of patients with mild to inactive disease. Fatigue is the commonest reason for work absence in IBD, and patients often report fatigue burden to be greater than that of primary disease symptoms. Relatively few evidence-based treatment options exist, and the aetiology is poorly understood. Aim:To review the available data and suggest a possible aetiology of IBD fatigue and to consider the efficacy of existing management strategies and highlight potential future interventions. Methods:We reviewed fatigue-related literature in IBD using PubMed database. Results: Disease related factors such as inflammation and pharmacological treatments negatively impact skeletal muscle and brain physiology, likely contributing to fatigue symptoms. Secondary factors such as malnutrition, anaemia, sleep disturbance and psychological comorbidity are potential determinants. Immune profile, faecal microbiota composition and physical fitness differ significantly between fatigued and non-fatigued patients, suggesting these may be aetiological factors. Solution-focused therapy, high-dosage thiamine supplementation and biological therapy may reduce fatigue perception in IBD. The effect of physical activity interventions is inconclusive. Conclusions: A multimodal approach is likely required to treat IBD fatigue. Established reversible factors like anaemia, micronutrient deficiencies and active disease should initially be resolved. Psychosocial intervention shows potential efficacy in reducing fatigue perception in quiescent disease. Restoring physical deconditioning by exercise training intervention may further improve fatigue burden.| 369 MCGING et al.

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“…To our knowledge, few studies have examined the relationship between endoscopic inflammatory disease activity, clinical disease activity, and fatigue (Grimstad et al, 2016; Jonefjäll et al, 2018). The purpose of this article is to determine the prevalence of fatigue by endoscopic inflammation and clinical disease activity and describe the factors associated with fatigue among adults with IBD.…”

Section: Introductionmentioning

confidence: 99%

“…Biomarkers of inflammation (e.g., C-reactive protein [CRP] and fecal calprotectin) can provide noninvasive measures and are well suited for monitoring inflammation over time; however, their sensitivity and specificity vary on the basis of disease subtype and location. among IBD patients with active and inactive clinical disease, the relationship between fatigue and inflammation, as measured with CRP and fecal calprotectin, produced mixed results (Grimstad et al, 2015(Grimstad et al, , 2016jonefjäll, Simrén, Lasson, Öhman, & Strid, 2018). a meta-analysis examining the relationship between biomarkers of inflammation and endoscopic inflammation reported sensitivity and specificity of CRP (0.49 and 0.92, respectively) and fecal calprotectin (0.88 and 0.73, respectively) (Mosli et al, 2015).…”

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confidence: 99%

Relationship Between Endoscopic and Clinical Disease Activity With Fatigue in Inflammatory Bowel Disease

Kamp

Clark‐Snustad

Barahimi

et al. 2022

Gastroenterology Nursing

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f atigue is a common and debilitating symptom reported by patients with inflammatory bowel disease (IBD) (Borren, Long, Sandler, & ananthakrishnan, 2020). fatigue is defined as an overwhelming sense of tiredness, lack of energy, and feeling of exhaustion (Hulme et al., 2018), common among recently diagnosed patients (Grimstad et al., 2015) as well as those with long-standing disease (Huppertz-Hauss et al., 2017). Cross-sectional studies in persons with IBD have noted that fatigue is the most prevalent symptom, even ahead of gastrointestinal symptoms (Conley,

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Conventional treatment regimens for ulcerative colitis alleviate fatigue – an observational cohort study

Cited by 10 publications

References 30 publications

Cognitive-behavioural therapy for the management of inflammatory bowel disease-fatigue: a feasibility randomised controlled trial

Cognitive-behavioural therapy for the management of inflammatory bowel disease-fatigue: a feasibility randomised controlled trial

Review article: The aetiology of fatigue in inflammatory bowel disease and potential therapeutic management strategies

Relationship Between Endoscopic and Clinical Disease Activity With Fatigue in Inflammatory Bowel Disease

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