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IBD Patients Report Relatively Greater Fatigue; Anxiety & Steroid Use Possible Links

Links between fatigue, anxiety, and steroid use in IBD patients.

hplictawa@gmail.com' by Editorial Team
May 24, 2022
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IBD Patients Report Relatively Greater Fatigue; Anxiety & Steroid Use Possible Links
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Medically reviewed by Onikepe Adegbola, MD, PhD 

IBD Patients Report Relatively Greater Fatigue; Anxiety & Steroid Use Possible Links
Image by Isabella and Zsa Fischer from Unsplash

Researchers from Italy have published an intriguing survey on patients with inflammatory bowel disease (IBD). The survey revealed that patients with IBD have greater fatigue than healthy controls. Additionally, the relatively greater level of fatigue in IBD patients was linked with the symptoms of anxiety and the use of steroids.

This survey research was titled “Fatigue and Associated Factors in an Immune-Mediated Inflammatory Disease Population: A Cross-Sectional Study.” This study was recently published in the Journal of Clinical Medicine. This study involved 39 patients with Crohn’s disease and 98 patients with ulcerative colitis. 

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Of the 137 IBD patients in this study, 75 (54.7%) reported fatigue versus 34.5% of healthy controls. The intensity of fatigue (average fatigue t-score of 52) was also significantly greater in IBD patients versus healthy controls (average fatigue t-score of 48). Thus, one in two IBD patients experienced fatigue in this study.

Interestingly, this study also had a third comparator group of 103 patients with inflammatory arthritis, such as rheumatoid arthritis and spondyloarthritis. Notably, the fatigue intensity in IBD patients was not significantly different from that in patients with inflammatory arthritis (average fatigue t-score of 54). This indicates that fatigue levels in IBD are as high as in inflammatory arthritis.

Why This Study is Important

This study simultaneously used the rigorous scientific tools of PROMIS® fatigue, anxiety, and depression item banks to assess the IBD patients’ symptoms compared with healthy controls and inflammatory arthritis patients. 

This study confirms the link between IBD and fatigue, which has been found in many earlier studies. Additionally, this study finds new links between fatigue and mood disorders. Therefore, this study recommends that patients with IBD, especially those with fatigue, should be treated comprehensively without overlooking these symptoms. 

What Did This Study Conclude?

This study gives the main message that fatigue is an important symptom affecting the quality of life of every other IBD patient. The effect of fatigue in IBD is as severe as that in inflammatory arthritis conditions, such as rheumatoid arthritis and spondyloarthritis. 

Moreover, fatigue is closely related to mood disorders. The relationship between fatigue and mood disorders needs more detailed study. Yet, IBD patients with fatigue may need to be evaluated for mood disorders by using a screening tool or a psychiatric referral.

Also, adequate management of IBD patients would include the management of fatigue as well. Holistic management is needed in patients with IBD who report fatigue and anxiety or depression that extends beyond the gastrointestinal system.  

 

Reference:

Iaquinta, F. S., Grembiale, R. D., Mauro, D., Pantano, I., Naty, S., Cosco, C., Iacono, D., Gaggiano, E., Ruggiero, A., Ciccia, F., Doldo, P., & Spagnuolo, R. (2022). Fatigue and Associated Factors in an Immune-Mediated Inflammatory Disease Population: A Cross-Sectional Study. Journal of clinical medicine, 11(9), 2455. https://doi.org/10.3390/jcm11092455

Tags: anxietyfatigueIBD
hplictawa@gmail.com'

Editorial Team

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A research paper was published in the Brazilian Journal of Biology, titled "Using Bifidobacterium and Propionibacterium Strains in Probiotic Consortia to Normalize the Gastrointestinal Tract." Based on expert opinions in the study, the microorganisms Bifidobacterium and Propionibacterium genera qualities can be preserved and encapsulated. This research backs up expert suggestions with clinical evidence, proving that the experts were correct. The gut microflora is responsible for regulating the body's activities and maintaining its health. Diabetes, obesity, inflammation, atherosclerosis, and other chronic diseases are due to dysbiosis. In the 2024 recommendations, experts recommended probiotics for living microorganisms that benefit the microflora and improve the health of the host organism helping prevent these diseases. Lactic acid bacteria from the Bifidobacterium and Propionibacterium genera are the frequent probiotics recommended. Bifidobacterium adolescentis-1909, Bifidobacterium longum infantis-1912, Propionibacterium jensenii B-6085, Propionibacterium freudenreichii -11921, Propionibacterium thoenii -6082, and Propionibacterium acidipropionici-5723 were examined for their probiotic characteristics in the study. This study was conducted in the Laboratory for Bio testing Natural Nutraceuticals at Kemerovo State University (Russia). The study used collection strains of the lactic acid bacteria Bifidobacterium adolescentis АС-1909, Bifidobacterium longum infantis АС-1912, Propionibacterium jensenii В-6085, Propionibacterium freudenreichiiВ-11921, Propionibacterium thoenii В-6082, and Propionibacterium acidipropionici В-5723. Lactic acid cultures were tested for antibacterial activity against the test cultures Salmonella enterica ATCC 14028, Staphylococcus aureusATCC 25923, Pseudomonas aeruginosa B6643, Proteus Vulgaris ATCC 63, and Listeria monocytogenes ATCC 7644. Additionally, the antibiotic resistance of lactic acid cultures was tested using the disk diffusion method. Bifidobacterium adolescentis-1909, Propionibacterium jensenii B-6085, and Propionibacterium thoenii 6082 showed moderate antibacterial activities against all test cultures. According to research, some Propionibacterium and Bifidobacterium strains, or their consortia, could be employed as probiotic cultures in dietary supplements or functional foods to prevent various chronic diseases like IBS. Why is this study important for patients with IBS Symptoms Although IBS is bothersome and inconvenient, it does not increase the chance of developing other health problems. However, the success of the treatment depends on what grade of IBS it is and how it is addressed. Bifidobacterium bacteria are particularly significant compared with other gut microbiota in probiotic cultures. Probiotics have a favorable effect in four ways. First, they produce antimicrobial compounds. Second, they are hostile to pathogenic and opportunistic strains. They also adhere to epithelial cells (cells of intestinal walls), posing a competitive threat to disease-causing bacteria. Finally, they inhibit the production of metabolites by pathogenic bacteria and cancer cells. What is the Key Takeaway from this Study Large doses of probiotics that contain these bacteria in dietary supplements or functional fermented milk products can stimulate their proliferation in the large intestine. The development of functional foods containing probiotics, particularly Bifidobacterium strains, is driven by the increased demand for health-beneficial foods. However, Propionibacterium 'dairy' strains have recently gained popularity. As a result, probiotic consortia of these species can be established to normalize the gastrointestinal microbiota's function. To preserve their quality, these microorganisms can be encapsulated (immobilized). All the strains can be employed to form various dietary supplements or functional product consortia.

A New Way To Improve Gut Health: Probiotic Consortia With Bifidobacterium And Propionibacterium Strains

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