Korean Medical College of Daejeon University, 62, Daehak-ro, Dong-gu, Daejeon 34520, Republic of Korea.
Research Center for CFS/ME, Daejeon Oriental Hospital of Daejeon University, 176 Daedeokdae-ro, Seo-gu, Daejeon 35235, Republic of Korea.
J Psychosom Res. 2024 Feb;177:111589. doi: 10.1016/j.jpsychores.2024.111589. Epub 2024 Jan 6.
Fatigue is a common symptom in both irritable bowel syndrome (IBS) and inflammatory bowel disease (IBD), including Crohn's disease (CD) and ulcerative colitis (UC). This study aimed to distinguish fatigue characteristics in IBS and IBD, two functional and organic disorders.
We systematically searched the PubMed and Cochrane Library databases from inception to June 30, 2023, and conducted a meta-analysis to generate precise estimates and 95% confidence intervals. The analyses were stratified by fatigue type, severity, sex, disease phase, and comorbidities, and study quality was assessed using Newcastle-Ottawa Scale (NOS).
Our analysis included 74 data (13 IBS, 31 CD, 30 UC) encompassing 16,689 participants (6484 males, 7402 females, and 2803 unknown). Overall, fatigue prevalence trended higher in IBS (54.5% [95%CI, 44.5-64.6]), followed by CD (49.8% [95%CI, 44.0-55.5]) and UC (43.6% [95%CI, 38.5-48.7]). This pattern persisted across sub-analyses, including general fatigue (63.4% vs. 51.3% vs. 45.3%) and moderate to severe fatigue (73.8% vs. 59.5% vs. 52.7%) for IBS, CD, and UC, respectively. Female predominance was observed in all three diseases (odds ratio: 1.5 in IBS and CD, 1.8 in UC). Fatigue prevalence significantly varied between disease phases (active vs. remission) in CD (61.3% vs. 36.3%) and UC (53.8% vs. 32.6%). Anemia, anxiety/depression, and/or IBS-like symptoms also contributed to fatigue in CD and UC.
This study is the first extensive comparison of fatigue prevalence and features in IBS, CD, and UC. The findings offer valuable insights for treatment and management, aiding our understanding of functional and organic diseases.
疲劳是肠易激综合征（IBS）和炎症性肠病（IBD）的常见症状，包括克罗恩病（CD）和溃疡性结肠炎（UC）。本研究旨在区分 IBS 和 IBD 的疲劳特征，这两种疾病分别是功能性和器质性疾病。
我们系统地检索了 PubMed 和 Cochrane Library 数据库，检索时间截至 2023 年 6 月 30 日，并进行了荟萃分析，以生成精确的估计值和 95%置信区间。分析按疲劳类型、严重程度、性别、疾病阶段和合并症进行分层，并使用纽卡斯尔-渥太华量表（NOS）评估研究质量。
我们的分析包括 74 项数据（13 项 IBS、31 项 CD、30 项 UC），涵盖了 16689 名参与者（6484 名男性、7402 名女性和 2803 名未知性别）。总体而言，IBS 的疲劳患病率较高（54.5%[95%CI，44.5-64.6%]），其次是 CD（49.8%[95%CI，44.0-55.5%]）和 UC（43.6%[95%CI，38.5-48.7%]）。这一模式在包括一般疲劳（63.4%比 51.3%比 45.3%）和中重度疲劳（73.8%比 59.5%比 52.7%）在内的所有亚分析中均存在，分别适用于 IBS、CD 和 UC。三种疾病均以女性为主（IBS 和 CD 的优势比为 1.5，UC 的优势比为 1.8）。CD（活动期 vs. 缓解期）和 UC（活动期 vs. 缓解期）的疲劳患病率在疾病阶段之间有显著差异（61.3%比 36.3%，53.8%比 32.6%）。贫血、焦虑/抑郁和/或 IBS 样症状也导致 CD 和 UC 出现疲劳。
这是首次对 IBS、CD 和 UC 中疲劳患病率和特征进行的广泛比较。研究结果为治疗和管理提供了有价值的见解，有助于我们理解功能性和器质性疾病。
