S1659 Prevalence of and Risk Factors for Fatigue in Inflammatory Bowel Disease in a Tertiary Care Center

Introduction: Fatigue is an increasingly recognized and multifactorial extra-intestinal manifestation of inflammatory bowel disease (IBD) that significantly impacts quality of life for up to 70% of patients (pts) with active IBD but also for pts in remission. We aimed to further characterize clinical, biochemical, and mental health risk factors for fatigue in a tertiary outpatient IBD clinic. Methods: This was a prospective study of pts with IBD who completed the Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F), Pittsburgh Sleep Quality Index (PSQI) questionnaires, and the Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder-7 (GAD-7) before or during clinic visits from Sept 2024 to May 2025. We also collected demographic, disease, laboratory, endoscopic, and radiologic data. Standard severity of fatigue scores were used (FACIT-F <30 is severe and 31-39 is moderate). Univariate analysis was conducted along with Chi-square and Wilcoxon rank-sum test. Simple linear regressions were fit for each predictor to estimate β-coefficients (change in FACIT-F score per unit change in predictor). Results: Among 220 pts, 77 (35%) had at least moderate fatigue. 129 (58.6%) were women, and 148 (67.3%) had CD, the median age was 42.4 years [IQR 33.1-55.5 years]. 151 pts completed a PHQ-9, and 42 (28%) had at least mild depression; 125 pts completed the GAD-7, and 34 (27%) had at least mild anxiety. On univariate analysis, clinically active IBD (β = -9.99, P < 0.001), greater anxiety (GAD-7; β = -1.57 per point, P < 0.001), history of mental health disorder (P < 0.001) and poorer sleep quality (PSQI; β = -9.84, P < 0.001) were significantly associated with more severe fatigue. Higher disease activity scores in IBD correlated with more severe fatigue (β = -2.08, P < 0.005, β = -5.71, P < 0.012, respectively). In pts with severe fatigue, 88% reported poor sleep quality vs 44% among those with mild or no fatigue (P < 0.001). Conclusion: We identify a high rate of fatigue in our pts with IBD and suggest a bidirectional relationship between inflammatory burden and fatigue which is also related to mental health disorders and poor sleep quality. These findings underpin the need for routine fatigue assessment and an integrated behavioral health, psychotherapy, and adjunctive medication plan in IBD management.