What causes fatigue in IBD?

There are many factors which may contribute to fatigue in IBD.

During a flare-up, fatigue may be caused by the body’s response to inflammation and illness, combined with:

  • exhaustion
  • disturbed sleep
  • pain
  • and anxiety

Anemia, a common complication of IBD, can add to fatigue.

It is unclear why fatigue does not always get better when the IBD does, and why it can continue even during remission.

One possibility may be that some people who think they are in remission and do not have any symptoms of IBD (such as diarrhea or bleeding), may still actually have some inflammation in the wall of the gut, which could be causing their fatigue.

If your IBD is completely in remission, then anemia may be contributing to your fatigue. Some people may have a persistently low level of hemoglobin in their blood, often caused by blood loss in stools, or low levels of iron or vitamins, which can mean they get exhausted easily.

In the Crohn’s and Colitis UK study, a number of other factors were suggested by people with IBD as possible causes for their fatigue. These included:

  • Diet and alcohol
  • Being overweight or underweight
  • Other health problems
  • IBD medication, in particular, steroids
  • Sleeping problems
  • Pain
  • Extremes of weather
  • Stress
  • Emotions such as depression and anxiety
  • Lack of support and understanding

Any, or a combination, of these factors may lead to fatigue. However, some people have no explanation for their fatigue.