Fatigue is a very common symptom in patients with inflammatory bowel disease (IBD) and is of concern because of its impact on quality of life.Researchers from University of Calgary and Athabasca University in Canada conducted a systematic review and meta-analysis to determine the prevalence and risk factors for fatigue in patients with IBD. Data was sourced from four online databases (Medline, Embase, CINAHL and PsycINFO) from inception to October 2019; 4524 studies were reviewed and 20 were selected for the final analysis. 

Results showed high (47%) overall pooled prevalence of fatigue. The study specific prevalence ranged from 24% to 87%. In six studies, the prevalence of fatigue in patients who had active disease was 72% compared to a prevalence of 47% of patients whose disease was in remission in seven studies. Fatigue was defined as chronic in some studies with a prevalence of 28%, while the prevalence was 43% in studies in which fatigue severity was defined as high. In patients with ulcerative colitis, the prevalence of fatigue was 36%, while in Crohn’s disease patients, the prevalence was 42%. In four studies, fatigue led to a decline in health-related quality of life. Statistically significant associations were noted between fatigue and sleep disturbance, anxiety, depression and anemia. This study illustrates the high prevalence of fatigue in IBD patients and the risk factors for fatigue. The prevalence of fatigue also varied by disease status and was high in patients with active disease. Fatigue should therefore be managed to enhance the quality of life for patients with IBD. 

DSilva A, et al. Clin Gastroenterol Hepatol. 2022 May;20(5):995-1009.e7.