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Review
. 2020 Jan;37(1):97-112.
doi: 10.1007/s12325-019-01151-w. Epub 2019 Nov 23.

Fatigue in Inflammatory Bowel Diseases: Etiologies and Management

Angelica Nocerino  1 , Andrew Nguyen  1 , Manasi Agrawal  2 , Anjali Mone  1 , Komal Lakhani  1 , Arun Swaminath  3
Affiliations
Review

Fatigue in Inflammatory Bowel Diseases: Etiologies and Management

Angelica Nocerino et al. Adv Ther. 2020 Jan.

Abstract

Fatigue is a burdensome, multidimensional, and multifactorial symptom that is associated with a wide array of chronic illnesses, specifically occurring in nearly 50% of patients with inflammatory bowel disease (IBD). Although common, given its subjective nature, physicians often under-recognize and undertreat this debilitating symptom. There are multiple etiologies that can contribute to fatigue in patients with IBD, including disease activity, anemia, medications, psychosomatic symptoms, and alterations to the gut-brain axis. The management of fatigue in IBD can be challenging, as it is often times multifaceted. In this review, we summarize the available tools for the diagnosis and measurement of fatigue, discuss etiologies, and make recommendations for their management. We identify knowledge gaps for the workup and treatment of fatigue and propose an algorithm to aid physicians in the evaluation and management of fatigue in this unique population. However, future research is needed to address several areas of knowledge deficits and improve the management of fatigue in IBD.

Keywords: Anemia; Crohn’s disease; Disease activity; Fatigue; Inflammatory bowel disease; Ulcerative colitis.

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Figures

Fig. 1
Fig. 1
Validated questionnaires for assessing fatigue in IBD
Fig. 2
Fig. 2
Algorithm for the systematic workup of fatigue and treatment based on the etiology. IBD inflammatory bowel disease, IMM immunomodulators
See this image and copyright information in PMC

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