Serious Crohn's Patients More Fatigued

Crohn's disease often makes patients more tired and lethargic

/ Author:  / Reviewed by: Joseph V. Madia, MD

(RxWiki News) Nearly two-thirds of patients with long-term major stomach troubles feel tired and weak.

New research better illustrates who exactly may be more at risk of feeling fatigued as part of having Crohn's disease.

"Our study underlines fatigue as an important contributing factor toward the burden of disease in Crohn's disease patients," the authors wrote in their report.

"See what your doctor recommends to help with fatigue."

Feeling tired and fatigued is common across a variety of chronic and inflammatory diseases, according to the authors. Crohn's disease is one of the most common inflammatory bowel disorders.

The study, led by Lauran Vogelaar, MD, in the Department of Gastroenterology and Hepatology at Erasmus Medical Center in the Netherlands, included 425 patients with Crohn's disease between October 2008 and January 2009.

A little more than 300 went to the referral hospital at Erasmus MC University Medical Center, as they had a more severe form of Crohn's. The others attended a general hospital.

Researchers surveyed patients at the beginning and end of the study on their anxiety, depression, level of fatigue and motivation, Crohn's activity and medication use.

What medical info was missing from patients' surveys was gathered through their medical records, as well as other demographic information. Researchers also measured each patient's blood cells and C-reactive protein levels, which have a greater presence when the body is inflamed.

They found that patients from the referred hospital had more symptoms and disease activity.

From that group, about 66 percent experienced fatigue compared to about 53 percent among patients that went to the general hospital.

The same held true for patients who had little to no stomachaches. Among those who went to the referred hospital, 53 percent were fatigued compared to 41 percent of in the other group.

They also had worse disease behavior, more side effects from the medication and more bowel resections. Females were significantly more likely to be fatigued compared to males.

In addition, those who used anti-TNF medications at the start of the study or had side effects to medications made with 5-aminosalicylic acid were likelier to be tired. But using anti-TNF medicine as a follow-up actually helps with fatigue.

"Patients treated with anti-TNF during follow-up showed improvement in fatigue," the authors wrote.

"This might indicate that fatigue in Crohn's disease patients should be targeted with effective medical treatment."

Patients with more disease activity or who had the disease a shorter period of time were likely to be fatigued as well. For those who have fewer Crohn's symptoms or upset stomachs, the authors say that "independent solution-focused therapy also seems to be effective in the treatment of fatigue."

"In addition, it has been reported that additional psychological treatment could play a role in improving fatigue, as psychological factors affect fatigue," the authors wrote.

The authors note their questionnaire on patients' current medication usage, so possible side effects to those meds is a limitation of the study.

The study also included a high percentage of women, which may not be representative of the population at large. More people with these long-term stomach problems however tend to be female.

The study was published online October 29 in the European Journal of Gastroenterology & Hepatology. The authors report no conflicts of interest with the study.

Reviewed by: 
Review Date: 
November 7, 2012
Last Updated:
November 9, 2012