McNelly, AS;
Nathan, I;
Monti, M;
Grimble, G;
Norton, C;
Bredin, F;
Czuber-Dochan, W;
... Forbes, A; + view all
(2016)
The effect of increasing physical activity and/or omega-3 supplementation on fatigue in inflammatory bowel disease.
Gastrointestinal Nursing
, 14
(8)
pp. 39-50.
10.12968/gasn.2016.14.8.39.
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Abstract
Objective: Fatigue is frequently reported by patients with inflammatory bowel disease (IBD), irrespective of disease activity; however, evidence regarding fatigue management is limited. This study tested the effect of individualised advice to increase physical activity and/or omega-3 fatty acids supplementation on fatigue in inactive IBD. / Methods: Patients in remission were recruited to a pilot study utilising a randomised controlled 2x2 factorial design (four groups) comparing baseline and postintervention fatigue scores. Study interventions (12 weeks): individualised exercise advice (15-minute consultation) and/or supplementation (omega-3 fatty acids, 2970mg/day). Control interventions: general health discussion and/or placebo supplement. Primary outcome was fatigue measured by Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F) scale score; secondary outcomes included change in Inflammatory Bowel Disease-Fatigue (IBD-F) scale score. / Results: From n=656 screened patients, n=74 who met the eligibility criteria (designed to remove confounding factors) were randomised, n=60 commenced, and n=52 completed the study. The primary outcome, fatigue measured with FACIT-F score, was worse with omega-3 supplementation (95%CI:-8.6-(-0.7);p=0.02), and unchanged with exercise advice (p=0.38). Fatigue, measured by IBD-F score, was reduced with exercise advice (95%CI:-3.8-(-0.2);p=0.03). One treatment-related adverse event (musculoskeletal pain) was reported with exercise. / Conclusions: Advice to increase physical activity and omega-3 supplementation, singly or in combination, were shown to be well-tolerated in IBD patients in remission. There was no evidence of exercise-related adverse effects on gut symptoms. Fatigue (IBD-F score) was reduced with exercise advice, but fatigue (FACIT-F score) was unchanged. Increasing fatigue with omega-3 supplementation is unexplained. Regular exercise may be a self-management option in IBD-related fatigue.
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