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Chronic Salmonella Infection Induced Intestinal Fibrosis
Published on: September 22, 2019
Fatigue and mood disorders are highly prevalent in patients with inflammatory bowel disease: a single-centre,
Andrew Chen1, Darren Wong1,2
1Department of Gastroenterology, Austin Health, Heidelberg, Victoria, Australia.
Background:
Fatigue is a common and debilitating symptom in inflammatory bowel disease (IBD), yet it remains under-recognised in clinical practice. This study aimed to quantify fatigue among Australian patients with IBD and examine associations with disease control, psychological distress and quality of life (QoL).
Methods:
We conducted a cross-sectional study of adult patients with IBD at a tertiary centre. Participants completed four validated questionnaires: Functional Assessment of Chronic Illness Therapy-Fatigue, IBD-Control 8, Short Inflammatory Bowel Disease Questionnaire and Hospital Anxiety and Depression Scale. Associations between fatigue and other patient-reported outcomes were analysed, and multivariate regression identified independent predictors of fatigue.
Results:
Of 1179 patients invited, 327 (28%) participated; 166 (51%) had Crohn disease, 152 (46%) ulcerative colitis and nine (3%) IBD-unclassified. Severe fatigue was reported in 46% of participants. Depression and anxiety were present in 29% and 41% of patients respectively. Fatigue was significantly associated with poorer disease control and QoL (P < 0.0001). On multivariate analysis, independent predictors of fatigue included depressive symptoms (β = -1.03, P < 0.0001), anxiety (β = -0.41, P = 0.003), reduced disease control (β = 0.70, P < 0.0001) and lower QoL (β = 0.23, P = 0.0006). Notably, in a subgroup of 55 patients (17%) with well-controlled disease, fatigue remained strongly linked with psychological distress and impaired QoL.
Conclusion:
Fatigue is highly prevalent in IBD and persists even among patients with good disease control. Psychological distress, poor disease control and reduced QoL are independently associated with fatigue, underscoring the need for routine screening and multidisciplinary management.
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