Fatigue in inflammatory bowel disease and its impact on daily activities
Corresponding Author
Philipp Schreiner
Department of Gastroenterology & Hepatology, University Hospital Zurich, Zurich, Switzerland
Correspondence
Philipp Schreiner, Department of Gastroenterology and Hepatology, University Hospital Zurich, Raemistrasse 100, 8091 Zurich, Switzerland.
Email: [email protected]
Search for more papers by this authorJean-Benoît Rossel
Center for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne
Search for more papers by this authorLuc Biedermann
Department of Gastroenterology & Hepatology, University Hospital Zurich, Zurich, Switzerland
Search for more papers by this authorPhilipp O. Valko
Department of Neurology, University Hospital of Zurich, Zurich, Switzerland
Search for more papers by this authorChristian R. Baumann
Department of Neurology, University Hospital of Zurich, Zurich, Switzerland
Search for more papers by this authorThomas Greuter
Department of Gastroenterology & Hepatology, University Hospital Zurich, Zurich, Switzerland
Search for more papers by this authorMichael Scharl
Department of Gastroenterology & Hepatology, University Hospital Zurich, Zurich, Switzerland
Search for more papers by this authorStephan R. Vavricka
Department of Gastroenterology & Hepatology, University Hospital Zurich, Zurich, Switzerland
Center of Gastroenterology and Hepatology, Zurich, Switzerland
Search for more papers by this authorValérie Pittet
Center for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne
Search for more papers by this authorPascal Juillerat
Department of Visceral Surgery and Medicine, Inselspital Bern University Hospital, Bern University, Bern, Switzerland
Search for more papers by this authorGerhard Rogler
Department of Gastroenterology & Hepatology, University Hospital Zurich, Zurich, Switzerland
Search for more papers by this authorRoland von Känel
Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
Search for more papers by this authorBenjamin Misselwitz
Department of Gastroenterology & Hepatology, University Hospital Zurich, Zurich, Switzerland
Department of Visceral Surgery and Medicine, Inselspital Bern University Hospital, Bern University, Bern, Switzerland
Search for more papers by this authorthe Swiss IBD Cohort Study Group
Search for more papers by this authorCorresponding Author
Philipp Schreiner
Department of Gastroenterology & Hepatology, University Hospital Zurich, Zurich, Switzerland
Correspondence
Philipp Schreiner, Department of Gastroenterology and Hepatology, University Hospital Zurich, Raemistrasse 100, 8091 Zurich, Switzerland.
Email: [email protected]
Search for more papers by this authorJean-Benoît Rossel
Center for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne
Search for more papers by this authorLuc Biedermann
Department of Gastroenterology & Hepatology, University Hospital Zurich, Zurich, Switzerland
Search for more papers by this authorPhilipp O. Valko
Department of Neurology, University Hospital of Zurich, Zurich, Switzerland
Search for more papers by this authorChristian R. Baumann
Department of Neurology, University Hospital of Zurich, Zurich, Switzerland
Search for more papers by this authorThomas Greuter
Department of Gastroenterology & Hepatology, University Hospital Zurich, Zurich, Switzerland
Search for more papers by this authorMichael Scharl
Department of Gastroenterology & Hepatology, University Hospital Zurich, Zurich, Switzerland
Search for more papers by this authorStephan R. Vavricka
Department of Gastroenterology & Hepatology, University Hospital Zurich, Zurich, Switzerland
Center of Gastroenterology and Hepatology, Zurich, Switzerland
Search for more papers by this authorValérie Pittet
Center for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne
Search for more papers by this authorPascal Juillerat
Department of Visceral Surgery and Medicine, Inselspital Bern University Hospital, Bern University, Bern, Switzerland
Search for more papers by this authorGerhard Rogler
Department of Gastroenterology & Hepatology, University Hospital Zurich, Zurich, Switzerland
Search for more papers by this authorRoland von Känel
Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
Search for more papers by this authorBenjamin Misselwitz
Department of Gastroenterology & Hepatology, University Hospital Zurich, Zurich, Switzerland
Department of Visceral Surgery and Medicine, Inselspital Bern University Hospital, Bern University, Bern, Switzerland
Search for more papers by this authorthe Swiss IBD Cohort Study Group
Search for more papers by this authorSummary
Background
Fatigue is a common symptom of chronic inflammation, including inflammatory bowel disease (IBD), resulting in significant impairment in quality of life.
Aims
To identify the prevalence of fatigue in a large IBD cohort compared to the general population, address risk factors, and evaluate its impact on daily life.
Methods
We evaluated 1208 IBD patients from the Swiss Inflammatory Bowel Disease Cohort Study (SIBDCS) and 414 healthy controls. Significant fatigue was defined as a visual analogue scale (VAS-F, range 0-10) score ≥ 4. Secondary endpoints were severity of fatigue and its impact on daily activities with the Fatigue Severity Scale (FSS), with a score ≥ 4 indicative of fatigue. Demographic, IBD-related and psychiatric symptoms were assessed with a multivariate analysis of variance (MANOVA) model optimised for prediction of VAS-F (primary outcome) and FSS scores.
Results
Overall, 672 IBD patients (55.6%) reported significant fatigue compared to 145 (35%) controls (OR 2.71; 95% CI 2.08-3.54; P < 0.001). In IBD, fatigue also significantly affected daily activities (FSS ≥ 4; 405 (33.5%) IBD patients vs 81 (19.6%) controls, P < 0.001). In the MANOVA model, fatigue levels were associated with female gender (coefficient 0.839; 0.556 - 1.123; P < 0.001), younger age at diagnosis (−0.031 per year; −0.042– −0.019; P < 0.001), shorter disease duration (−0.036 per year; −0.050– −0.022; P < 0.001), nocturnal diarrhoea (0.718; 0.295-1.141; P = 0.001), low educational level (P = 0.034) and symptoms of depression and anxiety.
Conclusions
Fatigue is both more frequent and more severe in patients with IBD than in the general population.
Open Research
DATA AVAILABILITY STATEMENT
The data that support the findings of this study are available on request from the corresponding author. The data are not publicly available due to privacy or ethical restrictions.
Supporting Information
| Filename | Description |
|---|---|
| apt16145-sup-0001-TableS1-S3.docxWord document, 19.2 KB | Table S1-S3 |
Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.
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