60 Impact of Disease Activity and Anemia on Fatigue in Inflammatory Bowel Disease Patients

Background: The burden of inflammatory bowel disease (IBD) continues to rise, with implications for patients’ quality of life, increased disability, and considerable economic strain on health-care systems. In IBD patients the presence of fatigue is prevalent and debilitating. Fatigue is defined as the impaired capacity to initiate or sustain a specific activity and is a multifactorial symptom associated with disease activity, nutritional deficiencies, physical inactivity, and sleep disorders. The recognition of fatigue in patients with IBD remains limited, and the lack of appropriate treatment strategies contributes to reduced quality of life and increased socioeconomic costs. Methods: A cross-sectional analysis was conducted in a quaternary IBD outpatient clinic from Latin America. Sociodemographic data and clinical characteristics of the patients were collected, and the FACIT-F questionnaire was administered to assess the impact of fatigue. The FACIT-F (Functional Assessment of Chronic Illness Therapy – Fatigue) questionnaire is a widely validated instrument for assessing fatigue in IBD patients, and a Brazilian version is available. It consists of 13 items rated on a 4-point Likert scale, with lower scores reflecting greater fatigue. Results: A total of 300 patients were assessed. The average patient age was 33.6 ± 15.7 years, with a balanced sex distribution: 53% female and 47% male. Comorbidities were present in 65.2% of the sample. The mean BMI was 25.5 ± 5.0 kg/m2, with a median of 24.9 kg/m2. A total of 174 patients (58%) had a diagnosis of Crohn’s disease (CD). Patients with ulcerative colitis (UC) showed greater fatigue (38.8 ± 11.1; P = 0.05) compared to those with CD (41.2±9.9). In this study, the association between depression and fatigue was statistically significant (33.2 ± 11.4; P < 0.001). The presence of clinical disease activity was correlated with fatigue (38.8±11.3; P = 0.016). Higher hemoglobin levels were associated with lower fatigue (P = 0.001). No statistically significant correlation was observed between fatigue and a history of prior surgery. Ferritin, vitamin B12, and albumin levels were not associated with fatigue. Conclusions: The presence of fatigue is prevalent among patients with IBD, UC patients presented higher levels of fatigue in our cohort. Clinical disease activity and anemia were statistically associated with the presence of fatigue. Patients diagnosed with depression experienced higher levels of fatigue. Systematic assessment of fatigue is paramount for optimizing patients’ quality of life and should be incorporated as a standardized component of clinical assessment.