Prevalence and Predictors of Fatigue in Patients With Inflammatory Bowel Disease in Saudi Arabia

Background:
Inflammatory bowel disease (IBD) is a growing health concern in the Western region of Saudi Arabia, and fatigue is an often overlooked symptom with scarcity of research on its impact on patients’ quality of life. Understanding the prevalence of fatigue and its associated factors in this region is crucial for effective management.
Methods:
This was a cross-sectional study that included patients with IBD attending a tertiary care hospital in the Western region of Saudi Arabia. Fatigue was assessed using the Fatigue Impact Scale, quality of life was assessed using the Short IBD Questionnaire (SIBDQ), pain was assessed using the MOS pain effect scale, and sleep quality was assessed using the Pittsburgh Sleep Quality Index. In addition, clinical variables (gender, IBD type, duration of IBD, and immunomodulator use) were also collected. Logistic regression was employed to examine the association between fatigue and these variables.
Results:
A total of 90 patients, 43% females and 74% Crohn’s disease, were included. Fatigue was prevalent among IBD patients, with 62% of participants reporting fatigue (95% CI: 43%–70%). Additional prevalence rates included: depression (39%; 95% CI 24%–49%), anxiety (46%; 95% CI 29%–56%), pain (52%; 95% CI 35%–63%), and poor sleep (43%; 95% CI 28%–53%). Significant predictors of fatigue risk included depression (OR: 2.5964, 95% CI: 1.2182, 147.7426), anxiety (OR: 4.1222, 95% CI: 5.6398, 674.8903), and pain (OR: 12.7555, 95% CI: 4.4117, 36.8803). Severity of fatigue was associated with the presence of depression (regression coefficient, RC = 0.20, 95% CI = 0.09 to 0.30) and pain (RC = 0.15, 95% CI = 0.04 to 0.25). Gender, IBD type, duration of IBD, immunomodulator use, and sleep were not significantly associated with fatigue. The SIBDQ scores were significantly lower in patients with fatigue compared to those without (52% vs 64%, p < 0.001).
Conclusions:
Fatigue is a common symptom among IBD patients in Western Saudi Arabia, with depression, anxiety, and pain emerging as significant predictors. The presence of depression and pain was associated with increased severity of fatigue. These findings highlight the importance of addressing psychological distress and pain management in IBD patients to improve their overall quality of life. Future studies should explore the underlying mechanisms linking these factors to fatigue and investigate effective interventions to mitigate its impact on IBD patients.