Non-invasive approaches to identify the cause of premature fatigue in Inflammatory Bowel Disease patients

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McGing, J.J. (2022) Non-invasive approaches to identify the cause of premature fatigue in Inflammatory Bowel Disease patients. PhD thesis, University of Nottingham.

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Abstract

Inflammatory bowel disease (IBD) fatigue is a pervasive secondary disease symptom. The aetiology is poorly understood, meaning that treatment options are sparse. This is of particular concern for the relatively large proportion of patients with quiescent disease, who continue to report an increased perception of fatigue and demonstrate premature exercise fatigue, relative to healthy individuals. Fatigue is multidimensional and can manifest as a disproportionate perception of tiredness, perturbed cognitive functioning and an inability to sustain a required work output during exercise.

In contrast to other chronic disease, to date there has been no mechanistic assessment of IBD fatigue reported in the literature. This is congruent with the essential absence of any effective treatment strategies convincingly shown to reduce IBD fatigue burden, independent of targeting known clinical causes.

The application of Magnetic Resonance Imaging (MRI) and Spectroscopy (MRS) techniques during exercise represents a unique opportunity to non-invasively probe in-vivo metabolism across multiple organs. This thesis seeks to characterise IBD fatigue aetiology by combining laboratory-based assessment of peripheral muscle function and cardiorespiratory fitness, with proton (1H) MRI and phosphorus (31P) MRS during within-bore exercise.

This thesis represents the first attempt to comprehensively interrogate IBD physiology with the aim of identifying potential treatment targets for fatigue.

Following an introduction to IBD in Chapter one, a detailed review of IBD fatigue aetiology follows in Chapter 2. Chapters 3 and 4 outline the methodology and developmental experiments undertaken to facilitate the MRI and 31P MRS experiments. Chapter 5 details the assessment of peripheral muscle function and body composition in quiescent Crohn’s disease patients relative to a healthy age and BMI matched control group. This is followed by the assessment of cardiovascular, brain and peripheral muscle deconditioning in Chapter 6 and 7.

A final discussion chapter is dedicated to a review of the collective findings of this thesis in the context of existing data within the literature base. Suggestions are then made for future research priorities in the field of IBD fatigue.

Item Type: Thesis (University of Nottingham only) (PhD)
Supervisors: Moran, G.W.
Francis, S.T.F.
Greenhaff, P.L.G.
Serres, S.
Keywords: Inflammatory bowel disease; Fatigue; In-vivo metabolism; Fatigue aetiology; Fitness; Physical exercise
Subjects: W Medicine and related subjects (NLM Classification) > WI Digestive system
Faculties/Schools: UK Campuses > Faculty of Medicine and Health Sciences > School of Medicine
Item ID: 71040
Depositing User: McGing, Jordan
Date Deposited: 03 Jul 2023 14:37
Last Modified: 03 Jul 2023 14:37
URI: https://eprints.nottingham.ac.uk/id/eprint/71040

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