{
  "abstract": "Introduction Fatigue in eosinophilic oesophagitis (EoE) remains under-characterised. Existing studies rely on generic quality-of-life measures, which consistently demonstrate reduced energy but correlate poorly with histological or endoscopic disease activity (Chang et al., 2021), while qualitative work identifies fatigue as a prominent patient concern (Taft et al., 2011; Mukkada et al., 2017). However, fatigue has not been prospectively assessed using a dedicated validated tool alongside established EoE activity measures. We therefore assessed fatigue in adults with EoE using the Fatigue Assessment Scale (FAS) and examined its relationship with endoscopic phenotype, eosinophilic activity, and symptom burden.Methods We conducted a fatigue audit for a clinical quality improvement project over 3 months (Sept–Nov 2025) of adults with confirmed EoE. Patients completed FAS at time of clinical review, and paired with the most recent gastroscopy, including those performed on the same day. FAS categories: no fatigue (10–21), fatigue (22–34), severe fatigue (≥35). Endoscopic phenotype was classified by EREFS scoring as inflammatory or fibrostenotic. Histologic active disease was defined as ≥15 eosinophils/high-power field. DSQ was available in a subset.Results Sixty-four adults with EoE completed the FAS with paired endoscopic and histological data (median age 47.5 years IQR 36.8-58.0; 67% male). All gastroscopies occurred within 2.5 years (median gastroscopy-to-FAS interval 41 days; IQR 0–107). 33/64 (51.6%) reported fatigue (FAS ≥22), including 5/64 (7.8%) with severe fatigue. Fatigue prevalence was similar between inflammatory and fibrostenotic phenotypes (any fatigue 48.0% vs 53.8%; χ 2=1.59, p=0.45). Fatigue was more common in histologically active disease (66.7% vs 42.5%), with higher rates of severe fatigue (12.5% vs 5.0%), but not statistically significant (χ2=3.84,p=0.15). In the DSQ subgroup (n=31), fatigue was more common in symptomatic than asymptomatic patients (68.4% vs 41.7%), and all severe fatigue occurred in symptomatic individuals. DSQ showed a weak correlation with FAS (r=0.26, p=0.09).Conclusions Fatigue was present in over half of this prospective EoE cohort but was not closely associated with endoscopic phenotype or eosinophilic activity. Symptom burden showed the strongest directional relationship, although not statistically significant. These findings highlight fatigue as a distinct aspect of EoE not captured by current disease activity measures, highlighting the need for dedicated fatigue assessment in future studies.Abstract P141 Table 1Fatigue severity in inactive vs active EoEFatigue CategoryInactive EoE (<15 eos/hpf) (n=40)Active EoE (≥15 eos/hpf) (n=24)TotalNo fatigue (FAS <22)23 (57.5%)8 (33.3%)31Fatigue (22–34)15 (37.5%)13 (54.2%)28Severe fatigue (≥35)2 (5.0%)3 (12.5%)5All fatigue (≥22)17 (42.5%)16 (66.7%)33Total402464",
  "authors": [
    {
      "affiliations": [
        "East and North Hertfordshire Teaching NHS Trust, Stevenage, United Kingdom"
      ],
      "name": "Rohith Kumar"
    },
    {
      "affiliations": [
        "East and North Hertfordshire Teaching NHS Trust, Stevenage, United Kingdom"
      ],
      "name": "Jo Brooks-Warburton"
    },
    {
      "affiliations": [
        "East and North Hertfordshire Teaching NHS Trust, Stevenage, United Kingdom"
      ],
      "name": "Danielle Morris"
    }
  ],
  "title": "P141 Beyond dysphagia: prospective evidence that fatigue is an under-recognised burden in eosinophilic oesophagitis",
  "uid": "74e54539-8c79-503b-88fc-e7e6da71cf59"
}