How Fatigue Is Experienced and Handled by Female Outpatients with Inflammatory Bowel Disease

Background. Fatigue is a significant aspect of everyday life for patients with inflammatory bowel disease (IBD), and it influences their health-related quality of life. Little is known about fatigue from the patient’s perspective. Aim. To investigate how female IBD patients experience and handle fatigue. Methods. The study included 11 female outpatients. These patients were 40–59 years old and had IBD ≥ one year and a significantly increased fatigue score. Patients with severe active IBD, anaemia, comorbidity, or pregnancy were excluded. The included patients agreed to participate in a semistructured interview. The interviews were analysed using Malterud’s principles of systematic text condensation. Results. The patients described physical and mental symptoms of fatigue that led to social-, physical-, and work-related limitations with emotional consequences. To handle fatigue, the patients used planning, priority, acceptance, exercise, and support. Two of the eleven patients used exercise on a regular basis. Surprisingly, some patients indicated that they did not need to talk with professionals about their fatigue unless a cure was available. Conclusion. Fatigue in IBD includes physical and mental symptoms that limit the patients’ social-, physical-, and work-related lives. Despite this, some patients expressed that they had chosen to accept their fatigue. 1. Background Inflammatory bowel disease (IBD), comprising Crohn’s disease (CD) and ulcerative colitis (UC), is a chronic medical condition with unknown aetiology, but genetic and environmental factors likely have an influence on progression of the disease. The symptoms can include diarrhoea, bloody stools, abdominal pain, and extraintestinal manifestations such as fatigue. Fatigue is a well-known symptom in chronic diseases, including IBD, and it is often connected to complaints and worries among IBD patients [1–3]. Despite the lack of an accepted definition of fatigue, it can be described as a persistent, overwhelming sense of tiredness, weakness, or exhaustion resulting in a decreased capacity for physical and/or mental work [4, 5]. Due to the lack of an accepted definition and the fact that fatigue is a subjective and unspecific symptom, it can be a challenge to adopt the right measurement tools for fatigue diagnosis and quantification [4]. This was expressed in a review from 2010 that identified 252 different ways to measure fatigue in chronic diseases, of which 150 have only been used once [6]. Over the last decade the interest in fatigue has increased [7]. However, a review from 2010 by van