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TOPLINE
Among patients with systemic sclerosis (SSc), clinically relevant fatigue was associated with a distinct profile of patient-reported gastrointestinal (GI) symptoms, particularly bloating and gastro-oesophageal reflux disease.
METHODOLOGY
- Researchers conducted a cross-sectional, observational study at a tertiary referral centre between January 2024 and December 2025 to identify GI symptoms associated with clinically relevant fatigue in patients with SSc.
- They included 115 adults with SSc (mean age, 62 years; 80% women) who had available assessment of fatigue.
- Fatigue was assessed using the Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-Fatigue) scale. A FACIT-Fatigue score of 30 or below was selected as an indicator of clinically relevant fatigue.
- GI symptoms included gastro-oesophageal reflux disease, dysphagia, bloating, diarrhoea, and constipation. The overall burden of GI disease was also assessed.
TAKEAWAY
- Overall, 36.5% of patients reported having clinically relevant fatigue. Compared with patients without clinically relevant fatigue, those with the condition more frequently reported gastro-oesophageal reflux disease (60.3% vs 90.5%), dysphagia (16.4% vs 40.5%), bloating (15.1% vs 66.7%), and diarrhoea (11.0% vs 28.6%; P < .05 for all).
- Bloating and gastro-oesophageal reflux disease were independently associated with 9.11-fold and 4.08-fold higher odds of clinically relevant fatigue, respectively (P < .05 for both). Dysphagia showed a positive but non-significant association, whereas diarrhoea and constipation were not independently associated with the condition.
- Patients with clinically relevant fatigue reported significantly greater disability and worse GI-related symptom burden, physical functioning, emotional well-being, and social functioning than those without fatigue.
- No significant differences were observed between patients with and without clinically relevant fatigue in terms of objective measures of disease severity including skin involvement, pulmonary disease, serologic profile, and inflammatory markers.
IN PRACTICE
"[The] findings suggest that the well-established relationship between GI involvement and fatigue in SSc is not uniform across the GI manifestations but appears to be primarily associated with a distinct profile of patient-reported symptoms, particularly bloating and GERD [gastro-oesophageal reflux disease]," the authors of the study wrote.
SOURCE
The study was led by Francesco Bonomi, University Hospital Careggi, Florence, Italy. It was published online on September 08, 2026, in Clinical Rheumatology.
LIMITATIONS
The cross-sectional design prevented establishing that GI symptoms caused fatigue. The reliance on patient-reported GI symptoms and fatigue may have introduced reporting bias and shared symptom perception. GI involvement was assessed symptomatically rather than through objective functional testing.
DISCLOSURES
This study did not report any specific funding. One author reported receiving support from the National Institute for Health and Care Research Manchester Biomedical Research Centre, conference support from UCB, and consultancy fees from Boehringer International and Novartis. Another reported receiving conference support from Boehringer Ingelheim and consultancy fees from Boehringer Ingelheim and GlaxoSmithKline.
This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.
