Perceived fatigue is comparable between different disease groups

Jones, DE; Gray, Joanne; Newton, Julia L.

doi:10.1093/qjmed/hcp091

Cited by 37 publications

(27 citation statements)

References 19 publications

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“…14 However, in the NHS in England and Wales only patients with fatigue who fulfil the Fukuda criteria for CFS can currently access specialist fatigue management services.…”

Section: Discussionmentioning

confidence: 99%

The Newcastle NHS Chronic Fatigue Syndrome Service: not all fatigue is the same

Newton¹,

Mabillard²,

Scott³

et al. 2010

JRCPE

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“…14 However, in the NHS in England and Wales only patients with fatigue who fulfil the Fukuda criteria for CFS can currently access specialist fatigue management services.…”

Section: Discussionmentioning

confidence: 99%

The Newcastle NHS Chronic Fatigue Syndrome Service: not all fatigue is the same

Newton¹,

Mabillard²,

Scott³

et al. 2010

JRCPE

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“…We have recently shown that the fatigue phenotype in a number of chronic diseases, including NAFLD, is comparable between chronic disease groups [32] , which would suggest that interventions applicable to one chronic disease group have the potential to be appropriate generically.…”

Section: Future Studiesmentioning

confidence: 99%

Systemic Symptoms in Non-Alcoholic Fatty Liver Disease

Newton¹

2010

Dig Dis

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Non-alcoholic fatty liver disease (NAFLD) is the most common liver disorder in the Western world and the incidence of the disease is constantly increasing. Most patients with NAFLD do not present with symptoms directly attributable to their underlying liver disease. It is increasingly recognized, however, that those with NAFLD describe a range of non-specific symptoms, which include fatigue and daytime sleepiness, may be the presenting problem and can impact dramatically upon quality of life in this patient group. The recognition of systemic symptoms in NAFLD has important implications for patients as many are potentially modifiable with targeted interventions. Fatigue appears to be a significant problem in NAFLD and the severity of fatigue is not associated with severity of NAFLD or any parameters of liver damage. Instead, fatigue in these patients shows a strong relationship with the symptom of daytime sleepiness and autonomic dysfunction. Daytime sleepiness can frequently be associated with obstructive sleep apnoea in those with NAFLD and is therefore treatable with evidence-based interventions. Recent studies have confirmed the presence of autonomic nervous system dysfunction in those with early stages of NAFLD. The presence of autonomic nervous system dysfunction leads to symptoms such as postural dizziness and syncope and is also associated with a number of clinical consequences in hepatic and non-hepatic diseases such as cognitive dysfunction, falls and fall-related injuries. On direct questioning, problems with memory and concentration are frequently described by those with NAFLD, with our studies confirming that 50% of NAFLD patients experience mild cognitive symptoms and up to 46% moderate or severe cognitive impairment. There were no positive correlations between cognitive symptoms and biochemical or histological markers of liver damage severity, confirming that cognitive impairment in early-stage NAFLD is not related to hepatic encephalopathy. Falls are also considered a direct consequence of autonomic nervous system dysfunction, and our work suggests that a history of falls is common in NAFLD (43%). The proportion of recurrent fallers is significantly higher in a NAFLD cohort compared to controls (p = 0.001), with injuries (p = 0.009), emergency medical attention (p < 0.001), fracture rates (p < 0.001) and hospital admission (p < 0.001) all significantly more common in the NAFLD group. Falls and the aforementioned associations were unrelated to the presence of diabetes or the severity of liver disease. A range of systemic symptoms appear to affect those with NAFLD, the severity of which is unrelated to the underlying liver disease severity. The presence of autonomic dysfunction may provide a unifying mechanism for these symptoms and a therapeutic target. Consideration of these symptoms affecting patients with NAFLD and, where possible, effective treatment will lead to improvements in quality of life and enhance the ability of those with NAFLD to function in their daily lives.

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“…Recruitment took place over a period of 13 Data were analysed on an intention-to-treat basis; however, results did not differ from those following per protocol analysis.…”

Section: Study Participantsmentioning

confidence: 99%

“…cancer, rheumatoid arthritis, and multiple sclerosis. Recent evidence suggests similarities in fatigue between different conditions [12,13], though it is unclear which elements of fatigue co-exist. Although physical activity (PA) has been suggested to be appropriate for adults and children with IBD [14,15], patients may raise concerns regarding exerciserelated exacerbation of their symptoms [16].…”

Section: Introductionmentioning

confidence: 99%

The effect of increasing physical activity and/or omega-3 supplementation on fatigue in inflammatory bowel disease

McNelly

Nathan

et al. 2016

Gastrointestinal Nursing

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Objective: Fatigue is frequently reported by patients with inflammatory bowel disease (IBD), irrespective of disease activity; however, evidence regarding fatigue management is limited. This study tested the effect of individualised advice to increase physical activity and/or omega-3 fatty acids supplementation on fatigue in inactive IBD. Methods:Patients in remission were recruited to a pilot study utilising a randomised Results: From n=656 screened patients, n=74 who met the eligibility criteria (designed to remove confounding factors) were randomised, n=60 commenced, and n=52 completed the study. The primary outcome, fatigue measured with FACIT-F score, was worse with omega-3 supplementation (95%CI:-8.6-(-0.7);p=0.02), and unchanged with exercise advice (p=0.38). Fatigue, measured by IBD-F score, was reduced with exercise 2 advice (95%CI:-3.8-(-0.2);p=0.03). One treatment-related adverse event (musculoskeletal pain) was reported with exercise. Conclusions:Advice to increase physical activity and omega-3 supplementation, singly or in combination, were shown to be well-tolerated in IBD patients in remission. There was no evidence of exercise-related adverse effects on gut symptoms. Fatigue (IBD-F score) was reduced with exercise advice, but fatigue (FACIT-F score) was unchanged.Increasing fatigue with omega-3 supplementation is unexplained. Regular exercise may be a self-management option in IBD-related fatigue.

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Perceived fatigue is comparable between different disease groups

Cited by 37 publications

References 19 publications

The Newcastle NHS Chronic Fatigue Syndrome Service: not all fatigue is the same

The Newcastle NHS Chronic Fatigue Syndrome Service: not all fatigue is the same

Systemic Symptoms in Non-Alcoholic Fatty Liver Disease

The effect of increasing physical activity and/or omega-3 supplementation on fatigue in inflammatory bowel disease

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