Prevalence and Factors Associated With Fatigue in Patients With Inflammatory Bowel Disease: A Multicentre Study

Chavarría, Carlos; Casanova, M J; Chaparro, María; Acosta, Manuel Barreiro‐de; Ezquiaga, Elena; Bujanda, Luís; Rivero, Montserrat; Argüelles-Arias, Federico; Martín-Arranz, María Dolores; Martínez-Montiel, María Pilar; Valls, Manuel; Ferreiro-Iglesias, Rocío; Llaó, Jordina; Moraleja-Yudego, I; Casellas, Francesc; Antolín-Melero, B; Cortés, Xavier; Plaza, Rocío; Pineda, Juan Ramón; Navarro-Llavat, M; García-López, Santiago; Robledo-Andrés, Pilar; Marín-Jiménez, Ignacio; García–Sánchez, Valle; Merino, Olga; Algaba, Alicia; Arribas-López, M R; Bañales, Jesús M.; Castro, Beatriz; Castro-Laria, Luisa; Honrubia, R; Almela, Pedro; Gisbert, Javier P.

doi:10.1093/ecco-jcc/jjz024

Cited by 66 publications

(60 citation statements)

References 43 publications

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“…Examining these relationships can inform our understanding of co‐occurring symptoms in IBD. The lack of a meaningful relationship between blood in the stool and fatigue in the current study is consistent with findings that anemia is often not associated with fatigue among individuals with IBD (Artom et al, ; Chavarria et al, ). Other nonsignificant findings may be due to the small sample size.…”

Section: Discussionsupporting

confidence: 92%

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: Discussionsupporting

confidence: 92%

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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“…Although the pathomechanism of fatigue is unclear and likely multifactorial, in chronic diseases, subclinical inflammation with elevated pro‐inflammatory cytokines, such as interleukin‐1 (IL‐1), soluble tumour necrosis factor (TNF) receptor type II, TNF, soluble IL‐6 17 and IL‐12 18 have been suggested as a trigger. However, in contrast to earlier trials, 6,19‐21 a recent prospective study of 544 IBD patients did not show an association between fatigue and disease activity in IBD 22 . Furthermore, other surrogate markers for higher disease activity, such as anti‐TNF therapy or anaemia did not show an association with fatigue 22 .…”

Section: Introductionmentioning

confidence: 67%

Fatigue in inflammatory bowel disease and its impact on daily activities

Schreiner

Rossel

Biedermann

et al. 2020

Aliment Pharmacol Ther

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SummaryBackgroundFatigue is a common symptom of chronic inflammation, including inflammatory bowel disease (IBD), resulting in significant impairment in quality of life.AimsTo identify the prevalence of fatigue in a large IBD cohort compared to the general population, address risk factors, and evaluate its impact on daily life.MethodsWe evaluated 1208 IBD patients from the Swiss Inflammatory Bowel Disease Cohort Study (SIBDCS) and 414 healthy controls. Significant fatigue was defined as a visual analogue scale (VAS‐F, range 0‐10) score ≥ 4. Secondary endpoints were severity of fatigue and its impact on daily activities with the Fatigue Severity Scale (FSS), with a score ≥ 4 indicative of fatigue. Demographic, IBD‐related and psychiatric symptoms were assessed with a multivariate analysis of variance (MANOVA) model optimised for prediction of VAS‐F (primary outcome) and FSS scores.ResultsOverall, 672 IBD patients (55.6%) reported significant fatigue compared to 145 (35%) controls (OR 2.71; 95% CI 2.08‐3.54; P < 0.001). In IBD, fatigue also significantly affected daily activities (FSS ≥ 4; 405 (33.5%) IBD patients vs 81 (19.6%) controls, P < 0.001). In the MANOVA model, fatigue levels were associated with female gender (coefficient 0.839; 0.556 ‐ 1.123; P < 0.001), younger age at diagnosis (−0.031 per year; −0.042– −0.019; P < 0.001), shorter disease duration (−0.036 per year; −0.050– −0.022; P < 0.001), nocturnal diarrhoea (0.718; 0.295‐1.141; P = 0.001), low educational level (P = 0.034) and symptoms of depression and anxiety.ConclusionsFatigue is both more frequent and more severe in patients with IBD than in the general population.

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“…In addition, we did not take into account some other factors that may contribute to fatigue, such as sleep quality, depression and anxiety. 26 In conclusion, high HSP90a plasma levels are associated with more severe fatigue in Crohn's disease, indicating that this protein may be a modulator of fatigue, possibly acting through intracerebral signalling pathways. HSP90a inhibitors should be tested in chronic inflammatory/IBD animal models as a novel treatment to attenuate sickness behaviour and fatigue.…”

Section: Discussionmentioning

confidence: 85%

“…We also included newly diagnosed and untreated patients in the current study, thus avoiding possible interference from medical treatment, such as corticosteroids, on fatigue severity. 26 This study has limitations. We did not analyse HSP90a concentrations in the intestinal mucosa, the target tissue for inflammation in Crohn's disease.…”

Section: Discussionmentioning

confidence: 92%

Heat-shock protein 90α in plasma reflects severity of fatigue in patients with Crohn’s disease

et al. 2019

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Heat-shock proteins (HSPs) are evolutionarily conserved proteins with important cellular homeostasis functions during harmful conditions, including inflammation. Some HSPs are secreted extracellularly and act on distant cells by down-regulating inflammation and increasing cellular stress defence mechanisms. HSP90α has been postulated to signal fatigue in chronic inflammation. We investigated whether HSP90α is associated with fatigue in patients with Crohn’s disease. Fifty-three patients with newly diagnosed Crohn’s disease were included in a cross-sectional study. Data on demographics and disease distribution were obtained. Fatigue was measured by the fatigue visual analogue scale (fVAS). Disease activity was assessed by the Simple Endoscopic Score for Crohn’s disease and Harvey Bradshaw Index. C-reactive protein, faecal calprotectin and HSP90α were also measured. The median fVAS score was 52 mm, indicating significant fatigue. HSP90α scores correlated significantly with fVAS ( r = 0.31, P = 0.03). In a multivariate regression model, HSP90α was the only significant contributor to fVAS scores (β = 0.31, P = 0.03). When patients were dichotomised into groups with high and low HSP90α concentrations, significantly higher fVAS scores were demonstrated in the group with high HSP90α ( M = 62.4, confidence interval 53.0–71.8 vs. 43.3, 31.6–55.0; P = 0.01). Thus, HSP90α may contribute to fatigue generation and/or modulation in patients with Crohn’s disease.

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Prevalence and Factors Associated With Fatigue in Patients With Inflammatory Bowel Disease: A Multicentre Study

Cited by 66 publications

References 43 publications

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

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

Fatigue in inflammatory bowel disease and its impact on daily activities

Heat-shock protein 90α in plasma reflects severity of fatigue in patients with Crohn’s disease

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