High prevalence of fatigue in patients with inflammatory bowel disease: association with physical activity intensity and sedentary behavior

Abstract

Introduction Fatigue is reported to be a common and disabling manifestation in patients with inflammatory bowel disease. Specialized units and nurse-led services play key roles in delivering holistic, long-term care for these patients. The aim of this study was to determine the prevalence of fatigue among inflammatory bowel disease patients attending a day hospital. The association between fatigue and physical activity was also analyzed, potentially providing clinically relevant information for nursing assessment and targeted interventions. Methods A descriptive, cross-sectional study was performed on a sample of 422 patients (Crohn's disease, 64.5%; colitis, 35.5%) attending the day hospital of the Son Espases University Hospital (Palma, Balearic Islands, Spain). Sociodemographic and disease characteristics, physical activity levels, and sedentary time were determined using a questionnaire. Data were analyzed using descriptive statistics. The primary statistical analyses consisted of comparisons between participants with and without fatigue and across fatigue severity levels using Student's t-test, one-way ANOVA, or Pearson's chi-square test, as appropriate. Results Most of the participants were in clinical remission (Crohn's disease, 95%; colitis, 71.1%). The prevalence of fatigue was 70.1%, with more than half of fatigued patients reporting a mild level of fatigue. Fatigue was found to be associated with depression and anxiety, with a higher prevalence of fatigue among the participants reporting to have these disorders (p = 0.010). Fatigue was associated with lower levels of physical activity (p = 0.002), mainly lower levels of intense physical activity, and in participants with severe fatigue. The participants with fatigue reported longer daily sitting times (p = 0.005). Furthermore, fatigue was associated with taking supplements (p = 0.016) and food avoidance (p < 0.001). Conclusions A high prevalence of fatigue was found among patients with inflammatory bowel disease. Exercise intensity and fatigue level were found to be key factors, with fatigue being negatively associated with participation in physical activity. Patients with fatigue, particularly those with severe fatigue, engaged in lower levels of physical activity, especially high-intensity exercise. However, walking and moderate-intensity exercise appeared to be well tolerated. Additionally, fatigue was associated with being sedentary for greater durations.