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Fatigue symptoms increase over time in IBD patients regardless of disease activity
Patients with IBD experienced increasing fatigue symptoms over time, even while in remission, though those with consistently inactive disease were less affected in a recent study.
Researchers evaluated data from 312 patients with IBD enrolled in the ongoing, prospective, longitudinal Manitoba IBD Cohort Study. The cohort had a mean age of 43 years (range 19 to 85 years), with an average disease duration of 6.4 years and disease type evenly divided between Crohn’s disease (CD, 51%) and ulcerative colitis (UC, 49%).
IBD symptoms were assessed according to the Manitoba IBD Index every 6 months over 2 years in each case, while psychological function, symptoms of fatigue and laboratory biomarkers were measured upon enrollment and at 1 and 2 years of follow-up. Fatigue symptoms were measured according to the Multidimensional Fatigue Inventory, and sleep quality was measured via the Pittsburgh Sleep Quality Index.
Disease was consistently active in nearly half of the cohort (45%) over the course of evaluation, with 26% maintaining inactive disease and 29% in fluctuation. Mean fatigue levels were significantly associated with disease activity, with the lowest fatigue levels observed among participants with consistently inactive IBD and the highest among those with consistently active disease.
Regardless of disease activity, fatigue levels increased modestly over time according to analysis via a mixed-effects regression model (P<.001). Factors associated with lower fatigue levels included consistently inactive disease (P<.0001 vs. consistently active disease), male sex (P<.001 vs. females) and advanced age (P=.017), while psychological distress (P<.001), poor sleep quality (P<.001) and a reduced sense of psychological well-being (P=.002) were linked to increased fatigue symptoms.
Lesley A. Graff
“I think the study validates the experience of many patients who struggle with fatigue, but often don’t get much confirmation or validation from the treating physician that it is a problematic symptom,” researcher Lesley A. Graff, PhD, associate professor in the department of clinical health psychology at the University of Manitoba in Winnipeg, Canada, told Healio.com. “… The findings suggest that it may be useful to consider psychological health in the care of the IBD patient, and to consider incorporating psychological therapies that might address stress and sleep, such as cognitive behavioral therapy.”
Disclosure: Researcher Charles N. Bernstein reported numerous financial disclosures.