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P196 Fatigue Severity and Factors Associated with High Fatigue Levels in Tunisian Patients with Inflammatory Bowel Disease

N. Ben Mustapha*, M. Mahmoudi, M. Bejaoui, A. Laabidi, L. Kallel, M. Serghini, M. Fekih, S. Matri, J. Boubaker, A. Filali

La Rabta Hospital, Gastroenterology A, Tunis, Tunisia


The prevalence of fatigue in the outpatient IBD population is not well described. To date, only a few studies in Western countries have focused on fatigue related to IBD, and fatigue has never been specifically studied in African IBD patients. The aim of the present study was to investigate the fatigue level among Tunisian IBD patients, to compare their scores with healthy controls, and to identify demographic and clinical factors that influence fatigue.


Patients with previously diagnosed IBD, >18 years of age, and who were in remission were eligible for inclusion in this study. Patients were not included if they had cognitive impairment and were judged by the investigator to be unlikely to comply with the study procedures.Fatigue was assessed using the Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F) in itss Arabic version. Corresponding healthy controls (HCs) also completed the fatigue questionnaire. Clinical and socio-demographic data was verified with chart review.FACIT-F scores range from 0 to 52, with lower scores indicating more fatigue and a score of less than 30 indicates severe fatigue. Tow patients were excluded because they did not complete the questionnaire.The study was performed according to the principles of Declaration of Helsinki, and informed consent was obtained from all participants.


Sixty one patients with Crohn's disease and 37 patients with ulcerative colitis (UC) were eligible for analysis, with a mean age of 32.8 years, male/female 68/30. The comparison group consisted of 200 HCs.There were no significant differences between patients with IBD and HCs with regard to sex, mean age and socio-economic conditions. When comparing UC patients and CD patients, there were no differences in FACIT-F and in all sub-dimensions between the IBDs. However, IBD patients had a mean FACIT-F score of 33.4, significantly lower than the HCs score of 42.1 (p<0.001). In all sub-dimensions of FACIT-F, both UC and CD patients showed significantly increased fatigue symptoms compared to HCs (all p<0.001). The prevalence of severe fatigue in IBD patients (FACIT-F<30) was 38.1% with females having more severe fatigue than males (p<0.001). Factors influencing the fatigue score included anemia and a high C-reactive protein.


Mean FACIT-F scores of Tunisian IBD patients are significantly lower than in HCs, indicating greater levels of fatigue in the IBD patients. Female patients have more fatigue. Anemia and CRP were determinants of fatigue in IBD patients. Physicians need to be aware of fatigue as one of the important symptoms of IBD to better understand the impact of fatigue on health-related quality of life.