Evaluation of fatigue in inflammatory bowel disease - a useful tool in daily practice

Abstract

Background: Fatigue is a common symptom reported in inflammatory bowel disease (IBD) patients. It can be severe and modify the self-perception of disease.

Objective: To evaluate the contribution of clinical and demographic factors to the level of fatigue in IBD patients.

Methods: Patients consecutively observed in an outpatient IBD clinic during a 9-month period were studied. Demographic and clinical data were collected. Fatigue was assessed using the Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F). A FACIT-F score <30 was considered as severe fatigue.

Results: One hundred and five patients were evaluated. Of them, 57.1% had Crohn´s Disease (CD) and 42.9% had Ulcerative Colitis. Also 85.0% and 77.8% were in clinical remission, respectively. The mean FACIT-F score was 39.63 ± 9.67. Severe fatigue was observed in 17.1% of patients. Female gender and active CD were significantly associated with a severe level of fatigue (p = .05 and p = .04). There was no significant correlation between the level of fatigue (severe vs. non-severe) and type of IBD, hemoglobin, C-reactive protein, ferritin levels or previous surgeries. Patients under biological therapy had a significantly higher level of fatigue and a higher rate of previous hospitalizations (p = .02).

Conclusions: Fatigue level is a simple and useful tool to evaluate the disease’s impact in patients’ life, and it should, therefore, be included in clinical practice. Biological therapy was associated to higher levels of fatigue. Future studies should evaluate the impact of therapy on the level of fatigue.

Keywords:

• Inflammatory bowel disease
• fatigue
• Crohn´s disease
• disease activity
• biological therapy

Acknowledgements

The authors thank David Cella PhD, for his permission to use the FACI T-F in this study and subsequent publication

Disclosure statement

Isadora Rosa declares having received a research grant from ABBVIE, having worked as a consultant for ABBVIE, FERRING, TAKEDA and JANSSEN and having received travel support for scientific meetings from ABBVIE, FERRING, MSD, TAKEDA, PHARMAKERN, JANSSEN and DR FALK PHARMA, outside the present study.

Dias Pereira declares having received travel support for scientific meetings from NORGINE and DR FALK PHARMA, outside the present study.

The remaining authors have no conflicts of interest to declare.

Ethical approval

Following our institution’s policy, this was an anonymous observational single-centre study that did not require informed consent or review/approval by the ethics committee.