Advertisement

Crohn’s Disease: Talking to Your Doctor About Fatigue

Fatigue is a common complication of inflammatory bowel disease, including Crohn’s disease. Learn how your healthcare providers can help you manage fatigue.

Crohn’s Disease: Talking to Your Doctor About Fatigue

Fatigue is a common symptom of Crohn’s disease as well as ulcerative colitis (the other main type of inflammatory bowel disease). There are a number of reasons that people who have Crohn’s disease may feel tired, exhausted, or worn down. Here, we look at some of the ways Crohn’s disease can contribute to fatigue and how to discuss fatigue with your healthcare providers.

One strategy that applies to all of the potential contributing factors listed below—talk to your healthcare provider about your energy levels and how you are feeling. Crohn’s disease is a different experience for everyone, and your healthcare providers are your best source of information about your health.

Inflammation
Under normal circumstances, inflammation is an immune response that protects the body from things like injury and infection by attacking and removing damaged tissue. However, inflammation can damage the body when it lasts too long or when it occurs in healthy tissue. When a person has an autoimmune disease, such as Crohn’s disease, the immune system attacks healthy tissue.

Inflammation results in fatigue for a number of reasons:

  • Like other processes in the body, the cells that cause inflammation require energy, which means less energy for other things.
  • Proinflammatory chemicals can disrupt the normal interaction of the nervous system and hormone-producing glands in the body.
  • Inflammation can impact appetite, making it difficult to eat, or eat enough.
  • Inflammation can also contribute to feelings of anxiety and depression, which can feel like fatigue.

If you are living with Crohn’s disease, keeping inflammation under control is an important focus of treatment. There are steps you can take to help keep inflammation under control:

  • Adhere to your treatment plan. There are several medications that are used to reduce and control inflammation. If you have been prescribed a medication for Crohn’s disease, it is important to follow your dosing schedule exactly as prescribed.
  • Avoid triggers. Triggers are things that cause symptoms to flare. Stress, smoking, certain medications (such as NSAIDs) and certain foods are common Crohn’s triggers.
  • Adopt a healthy lifestyle. Regular exercise and eating a nutritious diet can help reduce inflammation. Talk to your healthcare provider about exercising safely and the foods you should be eating.

Malnutrition
Inflammation or damage in the digestive tract can disrupt the normal digestion of food and absorption of nutrients. Pain, cramping, diarrhea, and other uncomfortable Crohn’s disease symptoms can make it difficult to eat or eat enough. As a result, people with Crohn’s disease are at risk for malnutrition and nutritional deficiencies.

Nutritional deficiencies that are common among people with Crohn’s disease include deficiencies in B12, calcium, folate, selenium, zinc, iron, and vitamin D.

Deficiencies in iron, B12, and folate can result in anemia, a condition where the body does not have enough healthy red blood cells to supply organs and tissues with oxygen. Blood loss, due to bleeding in the digestive tract, can also contribute to anemia.

Bloodwork and exams can help identify nutritional deficiencies and your healthcare providers can recommend ways to address deficiencies. This may include changes to diet and adding vitamins and/or supplements to your diet. People with Crohn’s disease may find it helpful to work with a registered dietitian or nutritionist.

Sleep disturbances
Many people with IBD, including Crohn’s disease, have trouble sleeping. Physical symptoms like pain, cramping, and gas can make it difficult to get a good night’s rest. The mental burden of the disease can also contribute to poor sleep quality. Changes in sleeping habits can also be a symptom of depression and anxiety.

If you are having trouble sleeping or have noticed a change in your sleep habits, share this with your healthcare provider. Poor sleep quality is also associated with higher disease activity and worse outcomes for people with IBD.

You should also talk to your healthcare provider about the moods, emotions, and feelings you are having. Mental and emotional health should be a focus of treatment for Crohn’s disease and IBD.

Medications
Fatigue is a side effect of many medications, including medications used to treat Crohn’s disease. Ask your healthcare provider if fatigue could be a side effect of the medications you are taking. Your healthcare provider may be able to suggest a different medication, or strategies for lessening fatigue.

Medically reviewed in November 2020.

Sources:
Angelica Nocerino, Andrew Nguyen, et al. "Fatigue in Inflammatory Bowel Diseases: Etiologies and Management." Advances in Therapy, 2020. Vol. 37, No. 1.
Mayo Clinic. "Crohn's disease symptom: Is fatigue common?"
National Institute of Diabetes and Digestive and Kidney Diseases. "Definition & Facts for Crohn’s Disease."
Crohn's & Colitis Foundation. "IBD and Fatigue."
National Institute of Diabetes and Digestive and Kidney Diseases. "Dictionary Definition: inflammation."
Cleveland Clinic. "Crohn's Disease: Prevention."
UpToDate. "Patient education: Crohn disease (Beyond the Basics)."
Harvard Health Publishing. "Living with Crohn’s disease: Recognizing and managing flares."
Crohn's & Colitis Foundation. "Exercise."
Crohn's & Colitis Foundation. "Nutrition."
National Institute of Environmental Health Sciences. "Inflammation."
F. Scaldaferri, M. Pizzoferrato, et al. "Nutrition and IBD: Malnutrition and/or Sarcopenia? A Practical Guide." Gastroenterology Research and Practice, 2017.
Christy Cauley and Richard Hodin. "Crohn Disease and Its Surgical Management." Shackelford's Surgery of the Alimentary Tract. Eighth Edition, 2019.
Johns Hopkins Medicine. "Vitamin B12 Deficiency Anemia."
Crohn's & Colitis Foundation. "Vitamin and Mineral Supplementation."
C. Marinelli, E. V. Savarino, et al. "Sleep disturbance in Inflammatory Bowel Disease: prevalence and risk factors – A cross-sectional study." Scientific Reports, 2020. Vol. 10.
Crohn's & Colitis Foundation. "Depression and Anxiety."
Jami A. Kinnucan, David T. Rubin, and Tauseef Ali. "Sleep and Inflammatory Bowel Disease: Exploring the Relationship Between Sleep Disturbances and Inflammation." Gastroenterology & Hepatology, 2013. Vol. 9, No. 11.
J. E. Kreijne, M. R. K. L. Lie, L. Vogelaar, C. J. van der Woude. "Practical Guideline for Fatigue Management in Inflammatory Bowel Disease." Journal of Crohn's and Colitis, 2016. Vol. 10, No. 1.

Featured Content

article

6 Drug Options for Crohn's Disease

Whether you have mild or severe IBD, these meds can help stop your symptoms.
article

What You Need to Know About Crohn’s Disease

Crohn’s doesn’t have to disrupt your life.
slideshow

6 Tips for Living Well with Crohn's Disease

Learn how to feel better each day with IBD.
article

How is Surgery Used to Treat Crohn’s Disease

Learn about the types of surgery that are used to treat Crohn’s disease and complications from Crohn’s disease.
article

Crohn’s Disease: 5 Topics to Discuss With Your Doctor

Questions and topics to help you prepare for an appointment with your healthcare provider.