title: Fatigue and health-related quality of life in inflammatory bowel disease: results from a population-based study in the Netherlands: the IBD-South Limburg cohort.
abstract: BACKGROUND
  The importance of fatigue in chronic disease has been increasingly recognized; however, little is known about fatigue in inflammatory bowel disease (IBD). The aim of the present study was to investigate the prevalence and severity of fatigue and the impact on health-related quality of life (HRQoL) in patients included in a population-based IBD cohort in the Netherlands.
  
  
  METHODS
  IBD patients, diagnosed between January 1st, 1991, and January 1st, 2003, were followed up for a median of 7.1 years. They completed a questionnaire, which included a disease activity score, the Multidimensional Fatigue Inventory (MFI-20), the Inflammatory Bowel Disease Questionnaire (IBDQ), and the Short Form health survey (SF-36). Hemoglobin levels were recorded.
  
  
  RESULTS
  Data were available in 304 Crohn's disease (CD), 368 ulcerative colitis (UC), and 35 indeterminate colitis (IC) patients. During quiescent disease, the prevalence of fatigue was nearly 40%. MFI-20 and HRQoL scores were significantly worse in IBD patients having active disease. In a multivariate analysis, disease activity was positively related with the level of fatigue in both CD and UC. In UC, anemia influenced the general fatigue score independently of disease activity. Disease activity as well as fatigue were independently associated with an impaired IBDQ.
  
  
  CONCLUSIONS
  In IBD, even in remission, fatigue is an important feature. Both in CD and in UC, fatigue determined HRQoL independently of disease activity or anemia. This implies that in IBD patients physicians need to be aware of fatigue in order to better understand its impact and to improve the HRQoL.
authors.affiliation: Department of Gastroenterology and Hepatology, Maastricht University Medical Center, the Netherlands. m.camps@orbisconcern.nl
authors.forename: M J L
authors.initials: MJ
authors.lastname: Romberg-Camps
authors.forename: Y
authors.initials: Y
authors.lastname: Bol
authors.forename: P C
authors.initials: PC
authors.lastname: Dagnelie
authors.forename: M A M
authors.initials: MA
authors.lastname: Hesselink-van de Kruijs
authors.forename: A D M
authors.initials: AD
authors.lastname: Kester
authors.forename: L G J B
authors.initials: LG
authors.lastname: Engels
authors.forename: C
authors.initials: C
authors.lastname: van Deursen
authors.forename: W H A
authors.initials: WH
authors.lastname: Hameeteman
authors.forename: M
authors.initials: M
authors.lastname: Pierik
authors.forename: F
authors.initials: F
authors.lastname: Wolters
authors.forename: M G V M
authors.initials: MG
authors.lastname: Russel
authors.forename: R W
authors.initials: RW
authors.lastname: Stockbrügger
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005221:Fatigue / Q000209:etiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000150:complications* / Q000175:diagnosis / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D011379:Prognosis; D011446:Prospective Studies; D011788:Quality of Life; D019057:Quality-Adjusted Life Years; D011795:Surveys and Questionnaires; D055815:Young Adult