P209 Prevalence and risk factors for fatigue in chronic inflammatory bowel disease
Hassine, A.(1);Hammami, A.(1);Braham, A.(1);Jaziri, H.(1);Jmaa, A.(1);
(1)Hôpital universitaire Sahloul, service de gastro-entérologie, Sousse, Tunisia
Fatigue is one of the most common symptoms reported by patients with chronic inflammatory bowel disease (IBD), being in flare or in remission. Thus, several fatigue measurement tools have been developed. The objective of our work was to assess the prevalence of fatigue in patients with IBD and its impact on daily life, and to determine its risk factors.
This is a cross-sectional study of patients followed for IBD who presented to our consultation during the three months preceding the study. Fatigue assessment was performed by IBD-F score (The Inflammatory Bowel Disease Fatigue Self-assessment Scale). The higher the score, the more disabling the fatigue. The activity of Crohn's disease (CD) was assessed by the Harvey-Bradshaw index (HBI), that of ulcerative colitis (UC) by the clinical Mayo score.
One hundred patients were included. Thirty-two patients (32%) had UC and 68 patients (68%) had CD. The mean age was 42.18 years [16-81 years], with a predominance of men (sex ratio = 1.5). Severe disease activity was noted in 14 patients (20.6%) with CD and 10 patients (31.3%) with UC. Extra-intestinal manifestations, particularly articular, were noted in 20% of cases. 36% of patients were in clinical remission. The prevalence of fatigue was 94.11% in MC and 93.75% in RCH. Fatigue was noted in 83.3% of patients in remission.Fatigue was severe (section I score between 11 and 20) in 40% of patients. We found a significant association and a linear correlation between the presence and severity of fatigue and CD activity (p <0.001, r = 0.84), as well as UC activity (p <0.001, r = 0.74). A significant association was found with extra-intestinal manifestations (p = 0.028), as well as with the presence of other chronic diseases (p = 0.014). In 30% of cases, fatigue was responsible for a functional handicap (section II score between 61 and 120). This effect was also strongly correlated with disease activity: MC (p <0.001, r = 0.74) and RCH (p <0.001, r = 0.73).
Assessing the severity of fatigue and its impact on the daily activities of patients is a crucial pillar in the management of patients with IBD. In our series, the prevalence of fatigue was 94%. It was associated and correlated with the degree of disease activity.