Conventional treatment regimens for ulcerative colitis alleviate fatigue - an observational cohort study.
OBJECTIVE
The aim of the study was to investigate the course of fatigue in a conventional inflammatory bowel disease treatment setting.


METHODS
Eighty-two patients with newly diagnosed ulcerative colitis were included in an observational cohort study and received conventional non-biological drug treatment for 3 months. Colonoscopy was performed at diagnosis and after 3 months, disease activity was assessed by Mayo score and measurements of serum C-reactive protein (CRP) and fecal calprotectin levels. Fatigue was evaluated using the fatigue visual analog scale (fVAS). Mood was assessed with the hospital anxiety and depression scale (HADS). Associations between fVAS scores and time; age; CRP, fecal calprotectin, hemoglobin, and ferritin levels; and Mayo scores, Mayo endoscopic scores, and HADS depression subscale (HADS-D) scores were explored.


RESULTS
Median fVAS scores decreased, as did Mayo scores and CRP and fecal calprotectin concentrations. HADS-D scores remained unchanged, whereas hemoglobin levels increased after 3 months. Increased fVAS scores were associated with higher ferritin, Mayo and HADS-D scores. There were no associations between fVAS scores and CRP, fecal calprotectin, or Mayo endoscopic scores. Colonic disease distribution did not influence fatigue significantly.


CONCLUSIONS
Disease activity and fatigue improved after 3 months of conventional ulcerative colitis treatment. Over time, more severe fatigue was associated with more ulcerative colitis symptoms, but not with objective disease activity markers or colonic disease distribution. A clinical setting of standard treatment regimens and medical attention may alleviate fatigue in IBD patients.
a Department of Internal Medicine , Stavanger University Hospital , Stavanger , Norway ;
Tore
T
Grimstad
a Department of Internal Medicine , Stavanger University Hospital , Stavanger , Norway ;
Katrine B
KB
Norheim
b Department of Mathematics and Natural Science , University of Stavanger , Stavanger , Norway ;|c Research Department , Stavanger University Hospital , Stavanger , Norway ;
Jan Terje
JT
Kvaløy
a Department of Internal Medicine , Stavanger University Hospital , Stavanger , Norway ;
Kjetil
K
Isaksen
a Department of Internal Medicine , Stavanger University Hospital , Stavanger , Norway ;
Kristian
K
Leitao
a Department of Internal Medicine , Stavanger University Hospital , Stavanger , Norway ;
Arne
A
Carlsen
a Department of Internal Medicine , Stavanger University Hospital , Stavanger , Norway ;
Lars N
LN
Karlsen
d Department of Medical Gastroenterology , Rikshospitalet University Hospital , Oslo , Norway ;
Lars
L
Aabakken
a Department of Internal Medicine , Stavanger University Hospital , Stavanger , Norway ;|e Department of Clinical Science , University of Bergen , Bergen , Norway.
Roald
R
Omdal
D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000032:analysis; D002097:C-Reactive Protein / Q000032:analysis; D015331:Cohort Studies; D003093:Colitis, Ulcerative / Q000150:complications* / Q000188:drug therapy*; D003113:Colonoscopy; D005221:Fatigue / Q000453:epidemiology*; D005243:Feces / Q000737:chemistry; D005260:Female; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D039841:Leukocyte L1 Antigen Complex / Q000032:analysis; D008297:Male; D019804:Mesalamine / Q000008:administration & dosage; D008875:Middle Aged; D009664:Norway; D012044:Regression Analysis; D012720:Severity of Illness Index; D055815:Young Adult
D000305:Adrenal Cortex Hormones; D015415:Biomarkers; D006454:Hemoglobins; D039841:Leukocyte L1 Antigen Complex; D019804:Mesalamine; D002097:C-Reactive Protein
Fatigue; inflammatory bowel disease; ulcerative colitis