Co-written by Alexandra Constantine
Fatigue is a common and challenging side effect for many individuals living with Crohn’s disease. This persistent tiredness can significantly impact daily life, affecting work, hobbies, and emotional well-being.
As both a registered dietitian specializing in IBD and the spouse of someone with Crohn’s disease, I have witnessed firsthand how debilitating fatigue can be. My husband has struggled with this symptom, and many of my patients have shared their own battles with relentless tiredness.
If you are experiencing fatigue associated with Crohn’s disease, read on to discover effective strategies for managing and overcoming this symptom.
What Does Crohn’s Fatigue Feel Like?
Fatigue can feel like never-ending tiredness, a lack of energy, or a feeling of exhaustion that does not go away after rest or sleep. It can be:
- Physical: Low energy or strength, feelings of heaviness
- Mental: A feeling of “brain fog”, low motivation, alertness, or concentration
- A combination of both physical and mental fatigue symptoms
Why Does Crohn’s Disease Cause Fatigue?
Fatigue in Crohn’s disease can be attributed to several factors:
- Inflammation of the gut: Triggers fatigue through inflammatory responses.
- Anemia: The most common anemia in Crohn’s is iron deficiency anemia. Learn more about Iron Deficiency Anemia.
- Psychological factors: Depressive mood, stress, anxiety, and impaired quality of life are strongly associated with fatigue. These symptoms are more common in Crohn’s patients than in the general population.
- Sleep disturbance: Disrupted or restless sleep and multiple awakenings occur more frequently compared to the general population.
- Nutrient deficiencies: Crohn’s patients are at higher risk of nutrient deficiencies due to chronic inflammation, malabsorption, and restrictive diets. Common deficiencies include Vitamin D, B12, and magnesium.
Key Nutrient Deficiencies That Can Lead to Fatigue
With inflammatory bowel disease, specifically Crohn’s disease, a loss of appetite or impaired absorption may be observed in patients, contributing to nutrient deficiencies.
Two key nutrients that can lead to fatigue are iron and vitamin B12. Symptoms associated with these deficiencies include:
- Iron: Sleepiness, headache, lack of appetite, nausea, pale appearance.
- Vitamin B12: Cognitive decline, constipation/diarrhea, confusion, poor memory.
For more information about nutrient deficiencies and IBD, I’ve prepared an IBD Nutrient Deficiencies Chart for key nutrients to be aware of.
Nutrition and Diet for Crohn’s Fatigue
While foods do not cause Crohn’s disease, they can trigger symptoms such as fatigue. Consulting with a registered dietitian can help you navigate food choices and create a personalized food plan. Here are some general, healthful eating tips for Crohn’s disease:
- Eat small meals or snacks every 3 to 4 hours.
- Stay well-hydrated by drinking small amounts of water continuously throughout the day.
- Introduce new foods one at a time, in small amounts.
- During flare-ups, follow the recommended food list provided for you.
- Incorporate anti-inflammatory foods such as turmeric, ginger, fatty fish, and leafy greens.
The main goal is to minimize symptoms and continue eating throughout the day, even when faced with chronic fatigue and tiredness.
Exercise for Crohn’s Fatigue
Individuals living with Crohn’s often engage in less physical activity due to feelings of tiredness and fatigue. However, research has shown that exercise positively impacts fatigue in Crohn’s patients. Here are some tips for exercise and Crohn’s disease:
- Opt for low-impact/moderate exertion exercises:
- Walking
- Bicycling
- Swimming
- Yoga
- Using an elliptical machine
- Try out different activities to find what you enjoy.
- If exercising outside, choose routes that allow for bathroom breaks when needed.
- Listen to your body. If you need to rest due to a symptom flare-up, take time off until your symptoms are under control.
- For beginners, start with short, manageable activities and gradually increase duration and intensity.
How to Fight Fatigue from Crohn’s Disease
To combat fatigue from Crohn’s disease, consider the following strategies:
- Manage iron and vitamin deficiencies by incorporating foods rich in these nutrients or using supplements.
- Review all medications with your healthcare provider to identify any contributing side effects.
- Reduce psychological and emotional stress through counseling, mindfulness practices, or support groups.
- Improve your sleep routine with tips such as maintaining a regular sleep schedule, creating a restful environment, and avoiding screens before bedtime.
Fatigue and tiredness from Crohn’s disease are nagging symptoms that can make everyday life challenging. Work closely with your registered dietitian and other healthcare providers to help identify and manage your fatigue symptoms.
References
- Regueiro, M., Delbecque, L., Hunter, T. et al. Experience and measurement of fatigue in adults with Crohn’s disease: results from qualitative interviews and a longitudinal 2-week daily diary pilot study. J Patient Rep Outcomes 7, 75 (2023). https://doi.org/10.1186/s41687-023-00612-9
- Fatigue and IBD. Crohn’s and Colitis UK. Accessed June 18, 2024. https://crohnsandcolitis.org.uk/info-support/information-about-crohns-and-colitis/all-information-about-crohns-and-colitis/symptoms/fatigue
- Włodarczyk M, Makaro A, Prusisz M, et al. The role of chronic fatigue in patients with Crohn’s disease. Life (Basel). 2023;13(8):1692. Published 2023 Aug 5. doi:10.3390/life13081692
- Zibdeh N. Crohn’s disease and diet. www.eatright.org. Published December 3, 2020. https://www.eatright.org/health/health-conditions/digestive-and-gastrointestinal/crohns-disease-and-diet
- Qiao R, Zhou Y, Ding T, Jiang X. Fatigue, physical activity, and quality of life in patients with inflammatory bowel disease: a cross-sectional study. Int J Gen Med. 2024;17:49-58. Published 2024 Jan 8. doi:10.2147/IJGM.S440652
- Exercise. Crohn’s & Colitis Foundation. Accessed June 18, 2024. https://www.crohnscolitisfoundation.org/patientsandcaregivers/campus-connection/navigating-college/exercise
- Managing Fatigue with IBD. Crohn’s & Colitis Foundation. Accessed June 18, 2024. https://www.crohnscolitisfoundation.org/patientsandcaregivers/pain-and-fatique/managing-fatigue