Is fatigue a common Crohn's disease symptom? What can be done about it?
Answer From Elizabeth Rajan, M.D.
Fatigue, an overwhelming sense of tiredness and lack of energy, is an all-too-common symptom of Crohn's disease. Fatigue can have a major impact on people who have Crohn's disease and ulcerative colitis, affecting their work, daily life and quality of life.
Besides direct effects from the disease, other factors that frequently affect people with Crohn's disease — pain, anxiety, depression, difficulty sleeping — also contribute to fatigue.
What can be done about it? Fatigue is a tricky problem with no easy answer. Here are a few ideas:
- Take steps to keep your disease well controlled. People whose disease is in remission have fewer complaints about fatigue. Medications that target inflammation help many people feel better, with less fatigue. Examples include biologic therapies such as adalimumab (Humira), certolizumab (Cimzia), infliximab (Remicade), and immunomodulators, such as azathioprine (Imuran, Azasan), mercaptopurine (Purixan, Purinethol) and methotrexate (Trexall).
- Treat anemia. A shortage of red blood cells is a common problem among people with Crohn's disease. It can contribute to low energy and fatigue. Talk to your doctor about supplements.
- Be sure you're getting adequate nutrition. Being low in certain vitamins and minerals, such as iron and vitamins B12 and D, can contribute to fatigue. Talk to your doctor about supplements.
- Talk to your doctor about your medications. Certain medications used to treat Crohn's disease, such as corticosteroids (prednisone), can lead to fatigue — either directly or by interfering with sleep.
- Seek psychological counseling. Consider talking to a doctor or a counselor about ways to manage fatigue and other psychological factors that can impact fatigue, including stress, anxiety and depression.
To fight fatigue, include physical activity in your daily routine, eat healthy foods, drink plenty of fluids, especially water, and get enough sleep. Be sure to share your concerns about fatigue with your doctor so that he or she can help find ways to address this issue.
Elizabeth Rajan, M.D.
Feb. 09, 2021
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See more Expert Answers
- Lichtenstein GR, et al. ACG Clinical Guideline: Management of Crohn's disease in adults. American Journal of Gastroenterology. 2018; doi:10.1038/ajg.2018.27.
- IBD and fatigue. Crohn's & Colitis Foundation. https://www.crohnscolitisfoundation.org/pain-and-fatigue/fatigue-causes. Accessed Dec. 2, 2020.
- Peppercorn MA, et al. Clinical manifestations, diagnosis and prognosis of Crohn disease in adults. https://www.uptodate.com/contents/search. Accessed Dec. 2, 2020.
- Living with Crohn's disease. Crohn's & Colitis Foundation. https://www.crohnscolitisfoundation.org/pain-and-fatigue/fatigue-causes. Accessed Dec. 2, 2020.
- AskMayoExpert. Crohn disease. Mayo Clinic; 2019.
- Van de Vijver E, et al. Fatigue in children and adolescents with inflammatory bowel disease. World Journal of Gastroenterology. 2019;doi:10.3748/wjg.v25.i5.632.
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