Fatigue in Irritable Bowel Syndrome: A Systematic Review and Meta-analysis of Pooled Frequency and Severity of Fatigue

Han, Claire J.; Yang, Gee Su

doi:10.1016/j.anr.2016.01.003

Cited by 32 publications

(43 citation statements)

References 48 publications

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“…Individuals with IBD commonly report “living with exhaustion” (Fourie, Jackson, & Aveyard, , p.152). It should be noted that because individuals with irritable bowel syndrome also experience high levels of fatigue (Han & Yang, ), fatigue may also be related to noninflammatory processes, such as genetic polymorphisms (Han, Jarrett, Cain, Jun, & Heitkemper, ).…”

Section: Discussionmentioning

confidence: 99%

Symptoms among emerging adults with inflammatory bowel disease: a descriptive study

Kamp

Dudley-Brown

Heitkemper

et al. 2019

Research in Nursing & Health

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Individuals with inflammatory bowel disease (IBD) are commonly diagnosed when they are between the ages of 18-29, a developmental period known as emerging adulthood. Typically, emerging adults are subsumed into the category of adults even though emerging adults have unique developmental needs. In this descriptive study of IBD in emerging adults, the aims were to (a) determine the prevalence of symptoms;(b) describe the severity of symptoms and their interference with daily activities; and (c) examine the association between individual symptom severity and presence of fatigue. Emerging adults with IBD were recruited using web-based convenience sampling. Sixty-one individuals met the inclusion criteria. They had a mean age of 24.7 and a disease duration of 6.4 years. The most prevalent symptoms reported were: fatigue (n = 44, 72.1%), abdominal cramps (n = 39, 63.9%), abdominal pain (n = 39, 63.9%), and diarrhea (n = 38, 62.3%). The symptom with the greatest severity and interference with daily activities was fatigue. Abdominal cramps, abdominal pain, diarrhea, passing gas, and abdominal tenderness were associated with fatigue when controlling for age, emerging adulthood, gender, time since diagnosis, and current steroid use. Among emerging adults with IBD, fatigue is the most prevalent symptom and is the symptom with the greatest severity and interference with daily activities.These results suggest a need for interventions aimed at reducing both fatigue and gastrointestinal symptoms among emerging adults with IBD.

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Section: Discussionmentioning

confidence: 99%

Symptoms among emerging adults with inflammatory bowel disease: a descriptive study

Kamp

Dudley-Brown

Heitkemper

et al. 2019

Research in Nursing & Health

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“…Intravenous infusion of LPS in healthy volunteers triggers visceral hypersensitivity with characteristics similar to those observed in IBS patients (25), and elevated plasma levels of LPS were associated with IBS (IBS-D) in a recent study (26). A separate study demonstrated elevated serum immunoglobulin A against LPS in patients with fatigue (27), a condition often linked to IBS (28). In the present study, similar blood levels of LPS in IBS patients and healthy controls were observed, with a slight increase in the mean LPS levels in the two groups following lactulose administration (statistically significant only in the healthy controls).…”

Section: Discussionmentioning

confidence: 99%

Systemic symptoms in irritable bowel syndrome: An investigative study on the role of enterocyte disintegrity, endotoxemia and inflammation

Undseth

Berstad

Valeur

2016

Molecular Medicine Reports

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Irritable bowel syndrome (IBS) is often accompanied by extra-intestinal symptoms, including fatigue and musculoskeletal pain. The present study aimed to investigate whether these symptoms were associated with markers of enterocyte disintegrity, endotoxemia and inflammation. Patients with IBS were recruited consecutively from our outpatient clinic (n=94) and compared with a group of healthy controls (n=20). Habitual symptoms were assessed using the IBS Severity Scoring System, the Fatigue Impact Scale and Visual Analogue Scales for measuring musculoskeletal pain. A lactulose challenge test was performed to induce post-prandial symptoms, and blood samples were obtained prior to and 90 min following lactulose ingestion to determine levels of intestinal fatty acid binding protein (iFABP), lipopolysaccharide (LPS), the LPS co-receptor soluble cluster of differentiation (sCD) 14, monocyte chemoattractant protein-1 (MCP-1) and calprotectin. Habitual symptom scores were high among the included patients, and lactulose ingestion induced significantly more symptoms in the patient group compared with the healthy control group (P=0.0001). Serum levels of iFABP were reduced in IBS patients compared with healthy controls, prior to and following lactulose ingestion (P=0.0002 and P=0.0001, respectively). Following lactulose ingestion, iFABP levels decreased in IBS patients (P=0.0001) and in healthy controls (P=0.02). Fasting levels of LPS, sCD14, MCP-1 and calprotectin were not significantly different between IBS patients and healthy controls. However, following lactulose ingestion, LPS levels increased in healthy controls (P=0.03), whereas MCP-1 levels decreased in IBS patients (P=0.008). Intestinal and extra-intestinal symptom severities were not correlated with levels of circulating biomarkers. No assessed biomarker in the present study appeared to be associated with symptom development in IBS patients. However, the implications of the low levels of iFABP observed require further investigation.

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“…In line with this, fatigue features prominently in several of the so-called functional somatic syndromes (FSS), which are characterized by different constellations of physical symptoms that are not attributable to any somatic disease ( Wessely et al, 1999 ). For instance, fatigue is the core symptom of chronic fatigue syndrome ( Fukuda et al, 1994 ), is a case-defining symptom of fibromyalgia syndrome ( Wolfe et al, 2010 ), and is one of the most frequently reported and most distressing symptoms in patients with irritable bowel syndrome, as recently confirmed by meta-analysis ( Han and Yang, 2016 ).…”

Section: Introductionmentioning

confidence: 99%

Thyroid Functioning and Fatigue in Women With Functional Somatic Syndromes – Role of Early Life Adversity

et al. 2018

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Objective: Fatigue is a core feature of functional somatic syndromes (FSS). Fatigue is also prominent in patients with thyroid diseases, which is unsurprising given the role of the hypothalamic-pituitary-thyroid (HPT) axis in regulating physiological energy demands. Research in healthy women has shown that early life adversity is linked with alterations in the HPT axis. In view of the substantial prevalence of early life adversity in patients with FSS, our aim was to investigate whether HPT functioning is related to (a) fatigue, and (b) early life adversity in these patients.Methods: N = 33 female patients with FSS and n = 30 age-matched controls were recruited. Fasting morning blood samples were taken to determine thyroid-stimulating hormone (TSH), free triiodothyronine (fT3), and thyroxine (fT4). General, physical, and mental fatigue were measured via the multidimensional fatigue inventory (MFI). Early life adversity was measured using the childhood trauma questionnaire (CTQ).Results: Patients with FSS did not differ from controls in any thyroid parameters (all p > 0.672). However, the lower the patients’ TSH and the higher their fT4, the greater was their general (β = -0.32, p = 0.064; β = 0.35, p = 0.038) and physical (β = -0.47, p = 0.007; β = 0.32, p = 0.077) fatigue. In addition, emotional neglect (β = -0.32, p = 0.057), physical neglect (β = -0.60, p = 0.001), physical abuse (β = -0.47, p = 0.015), and sexual abuse (β = -0.40, p = 0.026) were linked with lower TSH.Conclusion: The lower TSH and the higher fT4, the more fatigue was reported by patients with FSS. In addition, lower TSH was linked with more early life adversity. Larger, prospective studies are warranted to determine whether HPT functioning may be a mediating pathway between early life adversity and fatigue in FSS.

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Fatigue in Irritable Bowel Syndrome: A Systematic Review and Meta-analysis of Pooled Frequency and Severity of Fatigue

Cited by 32 publications

References 48 publications

Symptoms among emerging adults with inflammatory bowel disease: a descriptive study

Symptoms among emerging adults with inflammatory bowel disease: a descriptive study

Systemic symptoms in irritable bowel syndrome: An investigative study on the role of enterocyte disintegrity, endotoxemia and inflammation

Thyroid Functioning and Fatigue in Women With Functional Somatic Syndromes – Role of Early Life Adversity

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