Relationships Between Abdominal Pain and Fatigue With Psychological Distress as a Mediator in Women With Irritable Bowel Syndrome.
Claire J Han, Monica E Jarrett, Margaret M Heitkemper
PMID 31913959WHAT IT FOUND
In women with irritable bowel syndrome, worse daily abdominal pain predicted more fatigue the next day.
Psychological distress partly explained this link, but pain still had a direct association with fatigue.
Key findings
01All 356 women reported at least mild abdominal pain, fatigue, and psychological distress, and fatigue was moderate to very severe on 36% of diary days.
02Women who had more abdominal pain overall also had more fatigue overall, and psychological distress explained part of that relationship.
03For the same woman, worse abdominal pain one day predicted more fatigue the next day, but fatigue did not predict worse abdominal pain the next day.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study was cross-sectional, so it cannot prove that abdominal pain caused fatigue or psychological distress. It used baseline diary data from two earlier trials, not a test of any treatment. Symptoms were mostly mild to moderate, so the results may not apply to patients with severe IBS. Participants were women and mostly Caucasian, so the results may not apply to men or other groups. Symptoms were self-reported in daily diaries, which can be affected by recall and response bias. Participants were recruited for trials, which may limit generalizability. Stress, sleep, and bowel pattern subtypes were not tested as possible alternative explanations.
Declared interests
The author declared no potential conflicts of interest.
The easy way to misread this
Do not conclude that reducing abdominal pain or psychological distress will reduce fatigue. This study found associations in daily diaries, not a treatment effect, and it could not prove causation.