Fatigue in inflammatory bowel disease

Fatigue is a burdensome, complex, and multifactorial symptom that is associated with a wide range of chronic diseases and occurs in nearly 50 % of patients with inflammatory bowel disease (IBD). Although common, physicians often fail to recognize the disabling nature of this symptom due to its subjective character and therefore treat it inadequately. Several factors can contribute to fatigue in IBD patients, including disease activity, anemia, medications, psychosomatic symptoms, and alterations in the gut-brain axis. Managing fatigue in IBD can be challenging as it is often multidimensional. This review summarizes the available tools for diagnosing and measuring fatigue, discusses its causes, and provides treatment recommendations. We identify knowledge gaps in the diagnosis and management of fatigue and propose an algorithm to help physicians assess and treat fatigue in IBD patients. However, further research is needed to close knowledge gaps and improve fatigue management in IBD.