What is the link between Crohn’s disease and fatigue?

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Crohn’s disease is a chronic condition that causes inflammation in the digestive tract. People with Crohn’s disease often experience periods of fatigue that can be severe and affect their daily activities. This fatigue can occur during flare-ups of symptoms and periods of remission.

Crohn’s disease is a type of ​​inflammatory bowel disease (IBD). It is a chronic condition that affects the digestive system and causes inflammation of the gastrointestinal tract.

Common symptoms of Crohn’s disease include:

Another common symptom of this condition is fatigue.

Fatigue is more than just feeling tired — a person with physical fatigue may find it physically challenging to carry out everyday activities. This can include climbing the stairs or walking short distances.

Mental fatigue may cause a person to find it difficult to concentrate and stay focused.

Is it common in Crohn’s?

there is a person sat backwards on a blue chair looking tired
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​​Fatigue is a common symptom that has links with a range of chronic illnesses, including Crohn’s disease.

One 2020 reviewTrusted Source states that fatigue affects almost 50% of people with IBD. According to the Crohn’s and Colitis Foundation, it can be even more common, affecting nearly 80% of people with IBD during a flare-up and 50% of those in remission.

Common causes of fatigue in people with Crohn’s

​​There are several things that a person with Crohn’s disease may experience that can cause fatigue. These include:

  • Inflammation: When inflammation occurs in the digestive tract, the body produces chemical signals in response to the inflammation. These chemical signals can cause tiredness and a lack of energy. They can also contribute to a feeling of fatigue.
  • Anemia: Approximately one-thirdTrusted Source of people with IBD have anemia. This means that their red blood cells cannot transport enough oxygen to their body’s tissues, which can make a person experience tiredness and weakness.
  • Nutritional deficiencies: People with Crohn’s disease may have low levels of vitamin B12Trusted Source, iron, and folatesTrusted Source. These deficiencies have links to weakness and fatigue.
  • Side effects of medications: Certain Crohn’s disease medications can also cause fatigue. This includes steroids that can interfere with a person’s sleep patterns, while immunomodulators, such as methotrexate and 6-MP, can also lead to fatigue.
  • Anxiety: People with Crohn’s disease have an increased riskTrusted Source of experiencing anxiety, of which fatigue is a symptom.
  • Prolonged poor sleep: Individuals with Crohn’s disease may experience poor sleep. This may be because certain symptoms, such as stomach pain, can interrupt their sleep. If a person experiences reduced quality sleep for a number of nights, it could lead to them developing fatigue.

How to manage serious, chronic fatigue 

Fatigue is a common symptom of Crohn’s disease. However, the condition is often under-recognizedTrusted Source in people with IBD, meaning medical professionals often do not treat this symptom in those with IBD.

However, a person can manage chronic fatigue in various ways. Below are some tips that someone with Crohn’s disease may find useful.

Managing anemia

Around 1 in 3 people with Crohn’s disease or ulcerative colitis have anemia. Irritation and swelling in the intestines can mean the body does not absorb iron as it should, leading to anemia.

Anemia can cause fatigue for people with Crohn’s disease. A person may wish to take oral iron supplements to help manage their anemiaTrusted Source. If this does not work, an individual can discuss taking intravenous iron with their doctor.

By reducing anemia, people may be able to help manage their fatigue.

Managing nutrition

A person may also wish to focus on adding more vitamin B12 and folates, or folic acid, to their diet. Research suggests that deficiencies of these nutrients can causeTrusted Source extreme fatigue.

People can get vitamin B12 from supplements or a variety of foods, includingTrusted Source:

  • animal liver and kidneys
  • clams
  • sardines
  • beef
  • tuna
  • fortified cereal
  • fortified nutritional yeast
  • dairy products, such as milk, cheese, and yogurt
  • some nutritional yeast products

Food manufacturers also fortify other foods with vitamin B12, including some types of soya milk and breakfast cereals.

Learn about the other symptoms of vitamin B12 deficiency.

A person can add folates to their diet by eating Trusted Source:

  • legumes, such as beans, peas, and lentils
  • asparagus
  • eggs
  • leafy greens
  • beets
  • citrus fruits, such as oranges, grapefruit, lemons, and limes
  • Brussel sprouts
  • broccoli
  • nuts and seeds
  • beef liver

Learn more about folate deficiency.

Treating inflammation

The body’s response to inflammation can cause fatigue. Therefore, if a person has Crohn’s disease, they may wish to treat their inflammation to help manage fatigue.

An individual could use biologic therapies, such as infliximab, to treat inflammation. Nonbiologic medicines for inflammation include immunomodulators.

Switching medications

If a person’s medication is causing their fatigue, they may wish to switch to a different medication. They can speak to their doctor, who may be able to suggest alternative treatment options.

Treating anxiety

Around 40%Trusted Source of people with IBD experience high anxiety levels. This may be related to symptoms, but it can also be present when individuals are not experiencing symptoms.

A person with Crohn’s disease may wish to seek counseling to help manage their anxiety. Other options include cognitive behavioral therapy or anxiety medications.

If an individual is experiencing anxiety due to Crohn’s disease, they can speak with a medical professional, who may be able to treat the condition.

Learn about the different types of mental health services available.

Improving sleep

A person can try several methods to improve their sleep, including these healthy sleep habits:

  • establishing a consistent bedtime routine
  • ensuring their bedroom is at a comfortable, cooler temperature when going to sleep
  • making sure their room is quiet and dark when going to sleep
  • avoiding looking at screens for up to an hour before going to sleep
  • avoiding eating shortly before going to sleep

Learn more tips for improving sleep.

Physical activity

Regular physical activity can help improve sleep and reduce the symptoms of fatigue. If a person is not very physically active, they could gradually introduce exercise into their routine as they are able.

Learn more about exercise for people with Crohn’s disease.

Avoiding smoking

An individual with Crohn’s disease should try to avoid smoking to help manage the symptoms of their condition. Cigarette smoking worsens the symptomsTrusted Source of Crohn’s disease, which can worsen and contribute to fatigue. By stopping smoking and reducing symptoms, individuals can help improve their fatigue.

Learn 11 tips on giving up smoking.

Crohn’s and chronic fatigue syndrome

IBD increases a person’s riskTrusted Source of developing chronic fatigue syndrome (CFS).

CFS is a long-term illness that can cause pain and extreme fatigue. It is a serious illness that can last a long time and affect an individual’s ability to perform everyday tasks.

Symptoms of CFS includeTrusted Source:

  • a reduced ability to perform tasks they would normally do
  • the feeling of a “crash” after physical or mental exertion
  • the development of sleep disorders, including vivid dreaming, restless legs, muscle spasms, and sleep apnea
  • dizziness
  • issues with memory
  • aches and joint pains

If a person feels that they have CFS, they need to speak with a medical professional.

Summary

A common symptom of Crohn’s disease is fatigue, which can occur during flare-ups of the condition and periods of remission.

A range of factors can cause this fatigue, including the body’s response to inflammation, anxiety about Crohn’s disease, anemia, nutritional deficiencies, and pain that affects sleep.

To manage fatigue, an individual with Crohn’s disease may wish to treat their inflammation, manage their anemia, follow a nutritious diet, and develop better sleep habits.

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Article by: Medically reviewed by Youssef (Joe) Soliman, MD — Written by Adam Rowden on July 26, 2021
Crohn’s and fatigue: Link and how to boost energy (medicalnewstoday.com)
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