Predictors of subjective fatigue in chronic gastrointestinal disease M. SIMRE ´ N*, J. SVEDLUND  , I. POSSERUD*, E. S. BJORNSSON* & H. ABRAHAMSSON* Departments of *Internal Medicine and  Psychiatry, Sahlgrenska Univer- sity Hospital, Go ¨ teborg, Sweden Correspondence to: Dr M. Simre ´n, Section of Gastroenterology and Hepatology, Department of Internal Medicine, Sahlgrenska University Hospital, S-41345 Go ¨ teborg, Sweden. E-mail: magnus.simren@medicine.gu.se Publication data Submitted 6 May 2008 First decision 14 May 2008 Resubmitted 11 June 2008 Accepted 13 June 2008 Epub Accepted Article 28 June 2008 SUMMARY Background Fatigue is a common, but poorly understood symptom in patients with chronic gastrointestinal (GI) diseases. Aim To evaluate factors of importance for fatigue in patients with chronic GI diseases, and to compare it with fatigue in the general population. Methods In all, 399 patients attending a GI out-patient clinic completed question- naires assessing fatigue, sleep disturbances, psychological general well- being and GI symptom severity. The patients were divided into two diagnostic groups: functional GI disorders (n = 112) and organic GI dis- eases (n = 287). The severity of fatigue was also evaluated in an age- and gender-matched group of 399 individuals from the general population. Results Both patient groups had more severe fatigue than controls and patients with functional GI disorders were more fatigued than patients with an organic GI disease. Fatigue was associated with psychological general well-being, GI symptom severity, gender, employment status and sleep disturbances. In a linear regression analysis, psychological general well- being (vitality, general health, self-control), sleep disturbances and employment status were independently associated with the severity of fatigue (adjusted R 2 = 55%). Conclusions Fatigue is a troublesome symptom in a subgroup of patients with chronic GI diseases. These patients have a high symptom burden as regards both GI and psychological symptoms, as well as sleep disturbances. Aliment Pharmacol Ther 28, 638–647 Alimentary Pharmacology & Therapeutics 638 ª 2008 The Authors Journal compilation ª 2008 Blackwell Publishing Ltd doi:10.1111/j.1365-2036.2008.03770.x