P-023 Chronic Fatigue Twenty Years After Diagnosis. Results From the IBSEN-Study

Fatigue is a prevalent symptom in patients with chronic diseases and has also been reported in IBD patients (1). Little is known however, whether fatigue remains as a problem over time in IBD patients. The aim of the present study was to investigate the frequency of fatigue as well as associations with disease activity in an inception cohort, 20 years after diagnosis (The IBSEN-study). All patients still alive and included in the IBSEN Study between1990 and 93 were invited to a scheduled 20 year follow-up visit between March 2011 and August 2014. A total of 577 patients were eligible for follow-up, of these 144 refused participation, had moved out of the area or were lost to follow-up, and thus 455 participated. In addition to physical examinations and interview, the patients completed a set of patient-reported outcome measurements including the Fatigue Questionnaire (FQ). FQ consist of 11 questions, each asking if there is less (of a problem) than usual (0), no more than usual (1), more than usual (2) or much more than usual (3), total score range 0–33. The same questions can be dichotomized (0 or 1), a dichotomized score of 4 or above combined with a duration of 6months or more defines that the patients have Chronic Fatigue (CF).Disease activity was measured with HBI and SCCAI. A total of 435/455 (96%) completed the FQ, age 53,8 yrs (range 27,4-94,0 yrs) M/F 213/222, UC/CD 289/146. Mean time from diagnosis was 19 years, range 17.9–23.6. The FQ total score was 133 in UC and 14.5 in CD patients, as compared to 12.2 in the Norwegian background population. CF was reported in 25% (37/146) of the CD patients compared to 19% (55/289) in UC patients (P = 0.13) and was twice as common as in the normal population (11%). SCCAI mean score was 1,3 and 2,1 in non-CF and CF patients respectively (P < 0.001), for HBI the scores were 3.1 and 4.7 for non-CF and CF respectively (P = 0.03). Neither UC nor CD patients reported mean scores indicating active disease (SCCAI or HBI >5). However, in the CD group 36% of those with CF had a HBI score of 5 or higher compared to 21% in the non-CF group, P = 0.07. Similar figures for SCCAI scores in UC was 3,8% (CF) and 7,4% (non-CF), P = 0.5. Fatigue measured as total fatigue score in IBD patients 20 years after diagnosis is comparable to the background population. Chronic fatigue occurs twice as often as in the background population and is more frequent in CD compared to UC patients. Disease activity measured with HBI or SCCAI seems to play a role for CF in patients with CD but not in UC patients. 1. Jelsness-Jørgensen LP, Bernklev T, Henriksen M, Torp R, Moum BA. Chronic fatigue is more prevalent in patients with inflammatory bowel disease than in healthy controls. Inflamm Bowel Dis. 2011 Jul;17(7):1564–72.