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Introduction
Inflammatory bowel disease, commonly known as IBD, refers to a collection of disorders that lead to persistent inflammation of the gastrointestinal tract. The two types of IBD are ulcerative colitis, which impacts the colon, and Crohn's disease, which can involve any part of the gastrointestinal segment.
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Various diagnostic tests are employed in the diagnostic process for Inflammatory Bowel Disease (IBD), particularly to differentiate between Crohn's disease and ulcerative colitis.
Diagnostic studies
A colonoscopy is the definitive screening test, distinguishing ulcerative colitis from other colon diseases with similar symptoms. During a colonoscopy test, inflamed mucosa with exudate ulcerations can be observed, and biopsies are taken to determine the histologic characteristics of the...
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Inflammatory bowel disease, or IBD, encompasses a group of disorders characterized by chronic inflammation or ulceration of the gastrointestinal tract.
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Chronic Bowel Disorders: Introduction01:17

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Chronic bowel diseases are a group of long-term conditions affecting the digestive tract, characterized by inflammation and damage to the gut lining. These conditions primarily include irritable bowel syndrome and inflammatory bowel disease.
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Crohn's disease is an inflammatory bowel disorder marked by chronic inflammation of the GI tract. Various treatment strategies for Crohn's disease are employed, such as immunomodulatory agents, glucocorticoids, and biologics or anti-TNF therapy. Azathioprine (Imuran), a commonly used immunomodulatory drug for Crohn's disease, is converted in the body to mercaptopurine, which inhibits purine biosynthesis and cell proliferation. Both are utilized in severe cases of Inflammatory Bowel...
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Upon diagnosis, managing Inflammatory Bowel Disease (IBD) involves addressing several crucial aspects. The primary goals include resting the bowel, correcting malnutrition, and providing symptomatic relief. Resting the bowel may consist of medications to reduce inflammation and promote healing. Correcting malnutrition is essential, often requiring dietary adjustments and nutritional supplements. Symptomatic relief aims to ease pain, diarrhea, and other discomforts in IBD.
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Fatigue in inflammatory bowel disease.

Ulrike von Arnim1, Karina Scholz2

  • 1Department of Gastroenterology, Hepatology and Infectious Diseases, University Hospital Magdeburg, Germany.

Best Practice & Research. Clinical Gastroenterology
|December 5, 2025
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Summary

Fatigue is common in inflammatory bowel disease (IBD), affecting nearly half of patients. This review offers tools and strategies to help physicians better diagnose and manage this complex symptom.

Keywords:
Disease activityFatigueGerman IBD-FInflammatory bowel disease

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Area of Science:

  • Gastroenterology
  • Clinical Medicine
  • Patient Experience

Background:

  • Fatigue is a prevalent and disabling symptom in nearly 50% of patients with inflammatory bowel disease (IBD).
  • Physicians frequently underestimate the severity of fatigue due to its subjective nature, leading to inadequate treatment.
  • Multiple factors contribute to fatigue in IBD, including disease activity, anemia, medications, and gut-brain axis alterations.

Purpose of the Study:

  • To review current diagnostic and measurement tools for fatigue in IBD.
  • To discuss the multifactorial causes of fatigue in the IBD population.
  • To provide evidence-based treatment recommendations and identify knowledge gaps.

Main Methods:

  • Comprehensive literature review of studies on fatigue in IBD.
  • Analysis of diagnostic criteria and assessment tools for fatigue.
  • Synthesis of data on contributing factors and treatment efficacy.

Main Results:

  • Identified various tools for fatigue assessment in IBD patients.
  • Highlighted key contributing factors such as disease activity, anemia, and gut-brain axis dysfunction.
  • Summarized current treatment strategies and acknowledged significant knowledge gaps.

Conclusions:

  • Fatigue in IBD is complex and requires a multidimensional management approach.
  • An algorithm is proposed to aid physicians in assessing and treating IBD-related fatigue.
  • Further research is crucial to improve the understanding and management of fatigue in IBD.