Impact of extra-intestinal manifestations on quality of life and chronic fatigue in patients with inflammatory bowel disease: A Moroccan cross-sectional study

Background: Extra-intestinal manifestations (EIMs) and chronic fatigue represent major contributors to disease burden in inflammatory bowel disease (IBD), significantly impairing patients’ quality of life and daily functioning.
Objective: To evaluate the prevalence and profile of EIMs and to assess their impact on functional status and chronic fatigue in Moroccan patients with IBD.
Methods: A descriptive cross-sectional study was conducted in the Department of Hepato-Gastroenterology at Hassan II University Hospital in Fez, Morocco. Patients with confirmed IBD presenting at least one extra-intestinal manifestation were included. Data were collected using a structured bilingual questionnaire assessing demographic characteristics, disease profile, EIMs, fatigue, and functional impact. Statistical analysis was performed using the Chi-square test.
Results: A total of 120 patients were included (median age: 37 years), with female predominance (61%). Crohn’s disease represented 64% of cases. Articular manifestations were the most frequent EIMs (86%), followed by hepatobiliary (7%), ocular (5%), and dermatological involvement (4%). Functional limitation was reported in 75% of patients, while sleep disturbances affected 44%. Chronic fatigue was present in 90% of patients and had a socio-professional impact in 40%. No significant association was found between fatigue or functional limitation and sex or type of IBD.
Conclusion: EIMs and chronic fatigue are major determinants of impaired quality of life in patients with IBD. Their systematic assessment and multidisciplinary management should be integrated into routine clinical practice.