Influencing Factors of Inflammatory Bowel Disease-Fatigue: A Path Analysis Model.

The sample was large, but the data were from one time point, so it cannot show that any factor caused fatigue. The online sample was mostly White and women, and it likely overrepresented people with internet access and literacy, so results may not apply to all adults with IBD. Fatigue, sleep, pain, anxiety, depression, social role satisfaction and physical activity were self-reported, and the analysis had no blood markers for inflammation, anemia or nutrition. People with ostomies or J-pouches were excluded, so the findings do not describe fatigue in those patients. The path model tested many possible links, so some associations may reflect the chosen model rather than a causal process.

The parent IBD Partners cohort was funded by the Crohn’s & Colitis Foundation, the Patient-Centered Outcomes Research Institute and a National Institutes of Health Center Grant. This secondary analysis was funded by the Alpha Alpha chapter of Sigma Theta Tau International. The authors reported no conflicts of interest, except Dr Long, who disclosed consulting with AbbVie, Takeda, Janssen, Pfizer, Salix, Prometheus, Valeant, Target PharmaSolutions and UCB, and research support from Takeda and Pfizer.

Do not conclude that increasing physical activity, improving sleep, reducing pain, treating anxiety or depression, or enhancing social role satisfaction will lower IBD fatigue. This was a cross-sectional survey and path model, not a treatment trial.