Berliner, S

Bredin, F

Czuber-Dochan, W

Darvell, M

Forbes, A

Gay, M

Grimble, G

McNelly, A

Monti, M

Nathan, I

Norton, C

Terry, H

UCL Discovery

 A. McNelly1, I. Nathan1, M. Monti2, G. Grimble1, C. Norton3, F. Bredin4, W. Czuber-Dochan3, S. Berliner5, M. Gay5, M. Darvell5, H. Terry5, A. Forbes6 Disclosure of Interest: A. McNelly, I. Nathan, C. Norton, W. Czuber-Dochan, A. Forbes:  Grant/ Research Support from National Lottery in collaboration with Crohn’s & Colitis UK;  S. Berliner, M. Gay:  Consultants for Crohn’s & Colitis UK;  M. Darvell, H. Terry: Employees of Crohn’s & Colitis UK. INFLAMMATORY BOWEL DISEASE AND FATIGUE:     THE EFFECT OF PHYSICAL ACTIVITY AND/OR OMEGA 3 SUPPLEMENTATION 1UCL, 2UCLH, 3KCL, London, 4Addenbrooke's Hospital, Cambridge, 5Crohn's and Colitis UK, St Albans, 6Norwich Medical School/UEA, Norwich, UK BACKGROUND Fatigue is frequently reported by patients with IBD, despite disease remission.  However, few previous intervention trials have specifically assessed this symptom.  Main fatigue outcomes:  • Significant deterioration in FACIT-F score (more fatigue) (95%CI: -8.6 to (-0.7); p=0.02) with omega-3 fish oil • Significant reduction in fatigue in exercise groups, measured by IBD-F Section I score (95%CI: -3.8 to -0.2; p = 0.03) CONCLUSIONS The apparent worsening of fatigue with fish oil is unexplained. Exercise and fish oil, singly or in combination, were shown to be safe and generally well-tolerated in IBD patients. There was no evidence of adverse exercise-related effects on gut-related symptoms, and some evidence of improvement in fatigue. Hence, regular moderate-vigorous exercise may provide self-management options in IBD-related fatigue. Figure 2: Frequency of adverse effects from exercise and/or fish oil supplement in IBD patients. N & V: nausea and vomiting.  AIM To test the effects on fatigue in  Inflammatory Bowel Disease (IBD) patients from: • Individual advice to increase physical activity (PA) and/or  • Supplementation with omega-3 fatty acids. METHODS Design: Randomised controlled 2x2 factorial pilot study comparing change-from-baseline scores in intervention and control groups.  Primary outcome: Change in FACIT-F (Functional Assessment of Chronic Illness Therapy - Fatigue) score. Main secondary outcomes: Change in fatigue survey scores including IBD-Fatigue (IBD-F); PA by monitors (Actigraph, Pensacola, US); adverse effects.  Eligibility: IBD remission; ≤2 portions oily fish/week; ≤ 60 minutes moderate-vigorous PA/week; no comorbidities causing fatigue; no depression.   Intervention: Control: Placebo supplement; diet diary. Exercise and placebo: Consultation (15 minutes) with personal trainer; activity and diet diary. Diet treatment:  Fish oil supplement (2.97g per day omega-3, “Take Omega 3”©, Edinburgh, UK); diet diary. Diet and Exercise: Consultation with personal trainer (15 minutes); activity and diet diary. All patients received follow-up support (email, telephone). Adverse events:  One treatment-related event (in exercise group); neither exercise nor fish oil were associated with likelihood of occurrence of adverse effects, including gastrointestinal symptoms. • No significant interactions between effects of exercise and fish oil on fatigue • No consistent trends in fatigue or PA levels across the various measures between the four treatment groups Table: Main fatigue outcomes: (*) Figures for patients with UC and unclassified IBD. (**) Figures for patients with Crohn's and unclassified IBD. (+) Odds Ratio (95% CI) reported. (++) Variable analysed on log scale. Ratio (95% CI) reported. FACIT-F: Functional Assessment of Chronic Illness-Fatigue; SCCI: Simple Clinical Colitis Index; HBI: Harvey Bradshaw Index; MVPA: Moderate-Vigorous Physical Activity; CRP: C-reactive protein; IBD-F: IBD-Fatigue score; MFI: Multidimensional Fatigue Inventory; IBDQ: Inflammatory Bowel Disease Quality of Life Questionnaire.    RESULTS   Figure 1: Enrolment of IBD patients and completion of protocol.  Baseline: Similar parameters for gender, age, disease location, past IBD activity, level of PA, or FACIT-F.   

Inflammatory bowel disease and fatigue: the effect of physical activity and/or omega-3 supplementation

http://discovery.ucl.ac.uk/1476903/1/DDF%20Fatigue%20poster%20170615.pdf

Inflammatory bowel disease and fatigue: the effect of physical activity and/or omega-3 supplementation

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