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P527. Effects of diet and physical activity interventions on fatigue in patients with quiescent ulcerative colitis

M. Sanges1, O. Donatore1, D. Trio1, M. Miniero1, A. Piacente1, M.G. Ceriello1, L. Florio1, D. Mattera1, R. Sollazzo1, A. D'Arienzo1, 1Federico II University of Naples, Gastroenterology Unit, Department of Clinical and Experimental Medicine, Naples, Italy

Background

Fatigue in ulcerative colitis (UC) is often to be considered an effect of disease activity. But when the disease is clinically inactive, many patients still suffer from fatigue suggesting that fatigue is related to other factors which could be important to identify to improve UC patients' well-being. The aim of our study was to evaluate the effects of diet and physical activity interventions on fatigue in patients with quiescent UC.

Methods

Seventy patients (M/F=40/30, median age 44 years) with quiescent UC were enrolled in the study. A six-month lifestyle intervention which included diet and physical activity was performed. All participants were prescribed a diet in which the estimated daily caloric needs was carried out according to physical activity and ideal body weight and the daily intake of individual nutrients was carried out according to recommended daily intake of nutrients. Moreover, moderate-intensity physical activity progressed to 60 minutes, 3 days per week was prescribed. Fatigue was assessed by the Multidimensional Fatigue Inventory (MFI), a 20-item, self-report instrument designed to measure five fatigue dimensions: general fatigue, physical fatigue, reduced activity, reduced motivation, and mental fatigue.

Results

Fifty-six patients completed the study. Two patients showed a reactivation of UC and were excluded. After six months of diet and physical activity interventions a significant reduction of MFI scores for general fatigue (12.93±2.46 vs 10.4 6±2.37; p = 0.01), physical fatigue (12.64±3.03 vs 10.17±2.37; p = 0.03), reduced activity (13.14±2.63 vs 10.77±2.05; p = 0.01), and mental fatigue (12.57±1.99 vs 10.31±1.49; p = 0.002) was seen. On the other hand a not significant reduction of MFI score for reduced motivation (11.79±1.89 vs 10.29±2.37; p = 0.07) was seen. Moreover, the percentage of patients with MFI score for general fatigue >12 was significantly reduced (51.8% vs 27.7%; p = 0.01).

Conclusion

The high prevalence of significant fatigue in patients with quiescent UC has implications for the clinician. The pathogenesis of fatigue in these patients is almost certainly multifactorial. Our data have shown that diet and physical activity interventions can improve fatigue in quiescent UC. If the improvement was due to psychological or biological factors remains to be elucidated.