Keywords
Fatigue
Influencing factors
Cross-sectional study
Submitted : 2026-06-20
Accepted : 2026-07-05
Published : 2026-07-20
Abstract
Objective: To investigate the prevalence of fatigue and identify its associated influencing factors in patients with inflammatory bowel disease (IBD), thereby providing an evidence base for targeted clinical interventions. Methods: A cross-sectional survey design was adopted. A total of 204 patients with confirmed IBD diagnoses were consecutively enrolled from the gastroenterology outpatient clinics and inpatient wards of a tertiary-level hospital in Shiyan, Hubei Province, China, between June 2023 and June 2024. Fatigue was assessed using the IBD-Fatigue (IBD-F) scale. Sociodemographic characteristics, disease-related parameters, inflammatory biomarkers, and psychological status were simultaneously collected. Univariable analyses and multivariable logistic regression were performed to identify independent determinants of fatigue. Results: Among the 204 enrolled IBD patients, 142 (69.61%) had fatigue (IBD-F ≥ 13). Univariable analyses revealed that sex, disease activity status, anemia, C-reactive protein (CRP) level, serum albumin level, sleep quality, anxiety, and depression were significantly associated with fatigue occurrence (all p < 0.05). Multivariable logistic regression identified active disease phase (OR = 3.12, 95% CI: 1.54–6.31, p = 0.002), comorbid anemia (OR = 2.87, 95% CI: 1.42–5.80, p = 0.004), elevated CRP (OR = 2.43, 95% CI: 1.21–4.88, p = 0.013), poor sleep quality (OR = 2.19, 95% CI: 1.10–4.36, P = 0.026), and comorbid depression (OR = 3.56, 95% CI: 1.76–7.19, p = 0.001) as independent risk factors for fatigue; serum albumin ≥ 35 g/L was identified as a protective factor (OR = 0.48, 95% CI: 0.24–0.96, p = 0.037). Fatigue was significantly and negatively correlated with health-related quality of life (r = −0.61, p < 0.001). Conclusion: The prevalence of fatigue in IBD patients is as high as 69.61%, and it is independently associated with disease activity, elevated inflammatory markers, anemia, sleep disturbance, and depression, significantly impairing patients' quality of life. Routine fatigue screening and comprehensive multidimensional management strategies should be integrated into standard IBD care.
References
Chinese Society of Gastroenterology, IBD Group, 2018, Consensus on the Diagnosis and Treatment of Inflammatory Bowel Disease (2018, Beijing). Chin J Gastroenterol, 38(5): 292–311.
Czuber-Dochan W, Ream E, Norton C, 2013, Review Article: Description and Management of Fatigue in Inflammatory Bowel Disease. Aliment Pharmacol Ther, 37: 505–516.
Abdulla M, Mohammed N, AlQamish J, et al., 2025, Quality of Life and Fatigue in Inflammatory Bowel Disease: A Systematic Review. Healthcare, 13: 2203.
Radford S, McGing J, Czuber-Dochan W, et al., 2021, Systematic Review: The Impact of Inflammatory Bowel Disease-Related Fatigue on Health-Related Quality of Life. Frontline Gastroenterol, 12: 11–21.
Czuber-Dochan W, Norton C, Bassett P, et al., 2014, Development and Psychometric Testing of Inflammatory Bowel Disease Fatigue (IBD-F) Patient Self-Assessment Scale. J Crohns Colitis, 8: 1398–1406.
Hatamnejad M, Shirvani M, Pourhoseingholi A, et al., 2023, Translation and Cross-Cultural Adaptation of the Persian Version of Inflammatory Bowel Disease-Fatigue (IBD-F) Self-Assessment Questionnaire. PLOS ONE, 18: e0288592.
Liebert A, Wileńska A, Czuber-Dochan W, et al., 2021, Translation and Validation of the Inflammatory Bowel Disease Fatigue (IBD-F) Patient Self-Assessment Questionnaire. Gastroenterol Rev, 16: 136–143.
Stoker A, Gruters A, Loon M, et al., 2023, Translation, Validation and Psychometric Properties of the Dutch Version of the Inflammatory Bowel Disease-Fatigue (IBD-F) Self-Assessment Scale. J Patient-Rep Outcomes, 7: 108.
Scholz K, Thomann A, Teich N, et al., 2023, Validation of the German Inflammatory Bowel Disease Fatigue (IBD-F) Questionnaire. Z Für Gastroenterol, 61: 164–171.
Wang Q, Wan Q, 2022, Translation and Reliability/Validity Testing of the Chinese Version of the Inflammatory Bowel Disease Fatigue Self-Assessment Scale. Chin J Nurs Educ, 19(2): 166–171.
Liu X, Tang M, Hu L, et al., 1996, Reliability and Validity of the Pittsburgh Sleep Quality Index. Chin J Psychiatry, 1996(2): 103–107.
Mikocka-Walus A, Knowles S, Keefer L, et al., 2016, Controversies Revisited: A Systematic Review of the Comorbidity of Depression and Anxiety with Inflammatory Bowel Diseases. Inflamm Bowel Dis, 22: 752–762.
Wang Q, Li J, Ding X, et al., 2024, Fatigue Status and Path Analysis of Influencing Factors in Patients with Inflammatory Bowel Disease. Chin Nurs Manag, 24(5): 663–668.
Truyens M, Lernout H, De Vos M, et al., 2024, Unraveling the Fatigue Puzzle: Insights into the Pathogenesis and Management of IBD-Related Fatigue Including the Role of the Gut-Brain Axis. Front Med, 11: 1424926.
Czuber-Dochan W, Dibley L, Terry H, et al., 2013, The Experience of Fatigue in People with Inflammatory Bowel Disease: An Exploratory Study. J Adv Nurs, 69: 1987–1999.
Bergamaschi G, Castiglione F, D'Incà R, et al., 2023, Prevalence, Pathogenesis and Management of Anemia in Inflammatory Bowel Disease: An IG-IBD Multicenter, Prospective, and Observational Study. Inflamm Bowel Dis, 29: 76–84.
Tasson L, Zingone F, Barberio B, et al., 2021, Sarcopenia, Severe Anxiety and Increased C-Reactive Protein Are Associated with Severe Fatigue in Patients with Inflammatory Bowel Diseases. Sci Rep, 11: 15251.
Emerson C, Skvarc D, Mikocka-Walus A, et al., 2024, People with Inflammatory Bowel Disease Prefer Cognitive Behavioral Therapy for Fatigue Management: A Conjoint Analysis. Dig Dis Sci, 69: 2345–2353.
Barnes A, Bryant R, Mukherjee S, et al., 2024, Depression Influences Fatigue in Inflammatory Bowel Disease Amongst Other Factors: A Structural Modeling Approach. Ther Adv Gastroenterol, 17: 17562848241271987.