Fatigue and its associated factors in microscopic colitis

Abstract

Background:Fatigue is a well-recognized symptom in patients with inflammatory bowel disease and irritable bowel syndrome (IBS), and has been associated with psychological comorbidity and impaired quality of life in both. However, features associated with fatigue in patients with microscopic colitis (MC) are less clear.Materials and methods:We conducted a cross-sectional survey of patients with a new diagnosis of MC including levels of anxiety, depression, somatization, quality of life, and IBS-type symptoms. Levels and impact of fatigue were assessed using the Inflammatory Bowel Disease Fatigue self-assessment scale. Mean scores were compared against various patient characteristics, and were also correlated with anxiety, depression, somatization, and quality-of-life scores.Results:In total, 129 patients with MC diagnosed between 2010 and 2015 returned completed postal questionnaires. Common histological subtypes were collagenous colitis (53.5%, n = 69) and lymphocytic colitis (38.8%, n = 50). Higher mean fatigue severity and impact scores were associated with the presence of irritable-bowel-syndrome-type symptoms, abnormal levels of anxiety and depression, and high levels of somatization (p < 0.0001 for all), but those reporting ongoing symptoms attributable to MC did not report significantly higher scores. There were significant positive correlations between total anxiety, depression, or somatization scores and fatigue severity and impact scores, and significant negative correlations with quality-of-life measures (p < 0.001 for all).Conclusions:Fatigue in MC appears to be associated with reporting IBS-type symptoms, psychological comorbidity and impaired quality of life. It may therefore represent an important target for treatment.

<p>Management of microscopic colitis: challenges and solutions</p>

“…The watery diarrhea is often associated with abdominal pain, urgency, incontinence, nocturnal symptoms, and/or weight loss 6,21. Fatigue has also been noted to be a prevalent symptom in MC, as reported by both Nyhlin et al and Kane et al22,23 Fatigue severity was associated with concurrent anxiety, depression, and somatization in MC 23. While a recent systematic review and meta-analysis showed that one in three patients with MC can have symptoms of irritable bowel syndrome, namely alterations in bowel habits and abdominal pain, the rate of symptoms was similar to the general population, despite recent case–control studies showing the opposite 24.…”

European guidelines on microscopic colitis: United European Gastroenterology and European Microscopic Colitis Group statements and recommendations

“…In a cross‐sectional survey of 151 MC patients, 52 (34.4%) reported IBS‐type symptoms and had higher levels of anxiety, depression and somatisation and impaired quality of life 179 . In another cross‐sectional survey of 129 patients with a new diagnosis of MC, fatigue severity resulted to be associated with IBS‐type symptoms, psychological comorbidity and impaired quality of life, with a negative correlation in HRQoL measures 188 . In a cross‐sectional study including 158 female MC patients, those with coexisting IBS‐like symptoms (55%) experienced worse psychological well‐being than those without.…”

“…179 In another cross-sectional survey of 129 patients with a new diagnosis of MC, fatigue severity resulted to be associated with IBStype symptoms, psychological comorbidity and impaired quality of life, with a negative correlation in HRQoL measures. 188 In a cross-sectional study including 158 female MC patients, those with coexisting IBSlike symptoms (55%) experienced worse psychological well-being than those without. Also, smoking and PPI were associated with gastrointestinal symptoms and impaired psychological well-being in MC patients.…”

“…186 HRQoL was impaired in those with a mean of ≥3 stools/day or a mean of ≥1 watery stool/day. 188 In a crosssectional study including 158 female MC patients, those with coexisting IBS-like symptoms (55%) experienced worse psychological well-being than those without. Also, smoking and PPI were associated with gastrointestinal symptoms and impaired psychological wellbeing in MC patients.…”

Microscopic colitis from the standpoint of modern gastroenterology

“…2) [2,4,22]. Кроме того, у пациентов с МК могут наблюдаться сильная усталость, тревога и депрессия [4,34]. Важно отметить, что большинство пациентов могут испытывать симптомы заболевания на протяжении 2-3 лет до установления диагноза [35].…”