Cross-sectional studies have identified high levels of fatigue in patients with active or quiescent inflammatory bowel disease, but there has been little attention to the long-term effects of fatigue in these patients.
Dr Lesley Graff and colleagues from Canada performed a longitudinal study of fatigue in patients with inflammatory bowel disease to determine its course and contributing factors.
Data were obtained from participants in the Manitoba Inflammatory Bowel Disease Cohort Study, a longitudinal population-based study.
Symptomatic disease activity was measured every 6 months for 2 years to characterize long-term disease patterns as active, fluctuating, or inactive, based on the validated Manitoba inflammatory bowel disease Index.
|Psychological factors are useful targets for intervention to reduce fatigue|
|Clinical Gastroenterology and Hepatology|
The research team collected data concurrently on fatigue, psychological function, and laboratory biomarkers at the point of study entry, and 1 and 2 years later.
Of the study participants, 26% had consistently inactive, 29% had fluctuating, and 45% had consistently active disease over the 2-year time period.
The researchers noted that mean levels of fatigue were strongly associated with disease activity; participants with consistently inactive disease had the lowest level of fatigue at each time point.
The research team found that fatigue levels increased over time regardless of disease pattern.
Adjusting for disease activity, disease type and age, sex, and psychological variables of distress, reduced psychological well-being and poor sleep quality were associated independently with increases in fatigue over time.
Dr Graff's team comments, "Fatigue can increase over time in patients with IBD, even when their disease is in remission."
"Psychological factors are useful targets for intervention to reduce fatigue."