A high prevalence of fatigue (70.1%) was found among patients with inflammatory bowel disease, with fatigue negatively associated with physical activity participation, particularly high-intensity exercise, and positively associated with longer daily sitting times.
Key Findings
Results
The prevalence of fatigue among IBD patients attending a day hospital was 70.1%, with more than half of fatigued patients reporting a mild level of fatigue.
Study sample consisted of 422 patients (Crohn's disease, 64.5%; colitis, 35.5%) attending the day hospital of Son Espases University Hospital, Palma, Balearic Islands, Spain.
Most participants were in clinical remission (Crohn's disease, 95%; colitis, 71.1%).
More than half of fatigued patients reported a mild level of fatigue.
Data were collected via a descriptive, cross-sectional study design using a questionnaire.
Results
Fatigue was significantly associated with lower levels of physical activity, particularly lower levels of intense physical activity.
The association between fatigue and lower physical activity levels was statistically significant (p = 0.002).
Lower physical activity was observed mainly at intense physical activity levels and in participants with severe fatigue.
Walking and moderate-intensity exercise appeared to be well tolerated by patients with fatigue.
Exercise intensity and fatigue severity were identified as key factors in the fatigue-physical activity relationship.
Results
Patients with fatigue reported significantly longer daily sitting times compared to those without fatigue.
The association between fatigue and longer daily sitting times was statistically significant (p = 0.005).
Greater sedentary duration was identified as a characteristic associated with fatigue in IBD patients.
Sedentary behavior was assessed using a questionnaire.
Results
Fatigue was significantly associated with depression and anxiety, with a higher prevalence of fatigue among participants reporting these disorders.
The association between fatigue and depression/anxiety was statistically significant (p = 0.010).
Participants reporting depression and anxiety had a higher prevalence of fatigue.
Comparisons between participants with and without fatigue were performed using Student's t-test, one-way ANOVA, or Pearson's chi-square test as appropriate.
Results
Fatigue was significantly associated with taking dietary supplements and food avoidance behaviors.
The association between fatigue and taking supplements was statistically significant (p = 0.016).
The association between fatigue and food avoidance was highly significant (p < 0.001).
Sociodemographic and disease characteristics were assessed using a questionnaire.
Background
Specialized units and nurse-led services were identified as playing key roles in delivering holistic, long-term care for IBD patients, including fatigue assessment and targeted physical activity interventions.
The study population attended a day hospital, where nursing assessment and interventions are delivered.
The authors highlighted that physical activity data could provide clinically relevant information for nursing assessment.
The cross-sectional study design limits causal inference about the direction of the fatigue-physical activity relationship.
What This Means
This research suggests that fatigue is extremely common among people living with inflammatory bowel disease (IBD), affecting about 7 in 10 patients in this study, even when most were in clinical remission (meaning their disease was under control). The study surveyed 422 IBD patients attending a specialist day hospital in Spain and found that fatigue was linked to depression, anxiety, dietary changes such as taking supplements and avoiding certain foods, spending more time sitting each day, and doing less physical activity — especially vigorous exercise.
Notably, the relationship between fatigue severity and exercise intensity was a key finding: patients with more severe fatigue engaged in the least high-intensity physical activity, though walking and moderate exercise appeared to be reasonably well tolerated even by those experiencing fatigue. This suggests that not all forms of physical activity are equally affected by fatigue, and gentler forms of movement may remain accessible to IBD patients struggling with tiredness.
This research matters because it highlights that fatigue in IBD is widespread and multifaceted, intertwining with mental health, diet, and lifestyle behaviors. The findings point to a potential role for healthcare professionals — particularly nurses in specialist IBD units — in routinely assessing fatigue and considering tailored physical activity guidance as part of patient care. Because this was a cross-sectional study (a snapshot in time), it cannot determine whether fatigue causes people to be less active or whether being less active worsens fatigue, so further research is needed to clarify this relationship.
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Herrera M, Aguiló A, Tauler P, Mingorance J, Ginard D, Puchol E, et al.. (2026). High prevalence of fatigue in patients with inflammatory bowel disease: association with physical activity intensity and sedentary behavior.. Frontiers in public health. https://doi.org/10.3389/fpubh.2026.1893458