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Restless legs syndrome is a relevant comorbidity in patients with inflammatory bowel disease

Abstract

Background and aims

In patients with inflammatory bowel disease (IBD), restless legs syndrome (RLS) may occur as an extraintestinal disease manifestation. Iron deficiency (ID) or folate deficiency/vitamin B12 deficiency (FD/VB12D) has previously been described to cause RLS. Here, we determined the prevalence and severity of RLS in IBD patients and evaluated the effect of iron and/or folic acid/vitamin B12 supplementation.

Methods

Patients were screened for ID and RLS by a gastroenterologist. If RLS was suspected, a neurologist was consulted for definitive diagnosis and severity. Patients with RLS and ID, FD, or VB12D received supplementation and were followed-up at weeks 4 and 11 after starting supplementation.

Results

A total of 353 IBD patients were included. Prevalence for RLS was 9.4% in Crohn’s disease (CD) and 8% in ulcerative colitis (UC). Prevalence for the subgroup of clinically relevant RLS (symptoms ≥ twice/week with at least moderate distress) was 7.1% (n = 16) for CD and 4.8% (n = 6) for UC. 38.7% of RLS patients presented with ID, FD, and/or VB12D. Most frequently ID was seen (25.8%; n = 8). Iron supplementation resulted in RLS improvement (p = 0.029) at week 4 in seven out of eight patients.

Conclusion

Although the overall prevalence of RLS in IBD did not differ to the general population, clinically relevant RLS was more frequent in IBD patients and, therefore, it is important for clinicians to be aware of RLS symptoms. Though for definite diagnosis and proper treatment of RLS, a neurologist must be consulted. Additionally, iron supplementation of IBD patients with ID can improve RLS symptoms.

Trial registration

ClinicalTrials.gov No. NCT03457571

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Authors and Affiliations

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Correspondence to Jochen Maul.

Ethics declarations

The study was approved (16 January 2014) by the ethics committee of the Charité – Universitätsmedizin Berlin, Campus Benjamin Franklin (reference EA4/132/13).

Conflict of interest

The authors declare that they have no conflict of interest.

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Becker, J., Berger, F., Schindlbeck, K.A. et al. Restless legs syndrome is a relevant comorbidity in patients with inflammatory bowel disease. Int J Colorectal Dis 33, 955–962 (2018). https://doi.org/10.1007/s00384-018-3032-8

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  • DOI: https://doi.org/10.1007/s00384-018-3032-8

Keywords

  • Restless legs syndrome
  • Inflammatory bowel disease
  • Iron deficiency
  • Crohn’s disease
  • Ulcerative colitis