Improving sleep and taking short walks or doing yoga can help manage IBD fatigue.
Inflammatory bowel disease (IBD) is a group of conditions that cause inflammation in the digestive system. The two most common forms are ulcerative colitis and Crohn’s disease. Fatigue is the biggest concern of people with IBD because of its significant effect on daily life. Several factors can contribute to and worsen fatigue, including anemia, low iron, vitamin B12, and vitamin D levels, pain, sleep disorders, insufficient exercise, mental health disorders (e.g., anxiety and depression), and inflammation.
These conditions are called immune-mediated because they’re a result of a disorder within the immune system. Genes are associated with IBD, but it is also thought to be triggered by one or more environmental factors.
The exact cause of IBD is not known. However, it’s thought to be a complex combination of a genetic predisposition and environmental triggers. However, not everyone who carries the genes develops the condition.
More than 240 genes have been identified as contributing to IBD. About 30 of these genes have a direct connection. IBD does tend to run in families, but not everyone in the family develops the disease. Several factors are associated with the potential development of IBD.
Not everyone who carries the genes for IBD develops the disorder. It’s thought this is because one or more factors may trigger it to develop. Some of these may include:
IBD is considered an immune-mediated condition. The body’s immune system plays a role in the development of this disease and its flare-ups, but it’s not yet completely understood.
It’s thought that the immune system may be targeting the normal bacteria in the gut. Over time, the balance of the gut microbiome is disrupted, which is called dysbiosis. This could be one factor in the development of IBD.
Medications that alter the makeup of bacteria in the gut may also be involved in the development of IBD. Some of these include nonsteroidal anti-inflammatory medications (NSAIDs) and antibiotics. Being exposed to these types of medications often and/or early in life may increase the risk of developing IBD for some people.
IBD can be diagnosed at any age. However, studies show ulcerative colitis most commonly occurs between the ages of 20 to 30 years. Crohn’s disease is diagnosed earlier, usually in a person’s teens and 20s. Another 16% of people are diagnosed after the age of 65 years. It’s estimated that only 4% of people are diagnosed before the age of 5 years.
Some geographic areas have higher rates of IBD. People of Ashkenazi Jewish descent (people of Jewish heritage mainly descending from Central and Eastern Europe) have a higher risk of developing the disease. Caucasian people also tend to be diagnosed with IBD at higher rates than other races.
IBD affects everyone differently and there are numerous symptoms.
However, fatigue is the biggest concern among people with IBD. It affects 80% of people with IBD with active disease and 50% of people with remission. Fatigue is more than just feeling tired; it’s an extreme tiredness that doesn’t resolve with adequate sleep. It can include a feeling of heaviness, low energy, and poor concentration, or brain fog, which can be unpredictable.
Irritable bowel syndrome (IBS) and IBD have many similar symptoms. but they are two different conditions with distinct treatments. People can live with both IBD and IBS at the same time. It may be difficult to determine which condition is causing symptoms.
IBD is an immune-mediated condition, whereas IBS is a disorder of gut-brain interaction. People who have IBD and who still have symptoms, even when the disorder is in remission, may also have IBS.
IBS does not cause symptoms of fever or rectal bleeding. It is often treated with lifestyle and dietary changes. Some people may find that medications are needed to control symptoms. Surgery is not used as a treatment for IBS.
IBD is most often diagnosed via a colonoscopy with biopsies (removing samples of tissue to be analyzed in a lab) to check for inflammation anywhere in the large intestine. A sigmoidoscopy is used to see the last section of the colon.
Your healthcare provider may include blood tests to provide additional information.
These may include:
Stool tests may also be requested to look for an infection, blood, or a protein called calprotectin. This protein tends to be more prevalent in the stool of people who live with an IBD.
Your healthcare provider may want additional imaging tests.
An upper endoscopy examines the esophagus, stomach, and first part of the small intestine (duodenum) to look for any signs of inflammation or unusual tissue. Biopsy tissue taken during the procedure is sent to a lab to examine for changes in the cells.
Finding inflammation in the small intestine is more challenging. More detailed imaging tests may be needed to look at the organs and structures in the abdomen.
These tests include:
Treating IBD involves medications, lifestyle changes, and surgery. Some medications are used short-term to stop inflammation while others are used long-term to prevent symptom flare-ups.
Different types of medications to treat IBD include:
There is no single overall plan. Consult with your healthcare provider to incorporate behaviors that support your health.
There are several different types of surgery for IBD. It depends on the type of IBD and which part of the digestive system is involved.
IBD causes inflammation, which can affect other parts of the body. It can also lead to complications. Working with a healthcare provider to understand risks and whether it is possible to prevent complications is an important part of living with IBD.
Complications within the digestive system can include:
Additional complications may include:
A diagnosis of IBD can bring on many challenges that can affect daily life. Consult with your healthcare provider to learn how to manage your symptoms.
IBD can affect mental health and people with IBD are at increased risk of anxiety, depression, and post-traumatic stress or post-traumatic stress disorder (PTSD).
Creating a care plan can help with all of the challenges of this condition.
This can include:
People with IBD can speak to their healthcare provider or ask at their local hospital or IBD center about available resources and support groups.
IBD will need to be managed over a lifetime. There is no way to reverse or cure these conditions. However, there are many ways to help manage them.
The most important part of managing IBD is to reduce the inflammation that leads to complications. This means finding a medication to reduce symptoms so they go into remission and then taking that medication consistently.
People with IBD may also want to avoid triggers associated with flare-ups. There is not enough evidence concerning what causes flare-ups, but there are still measures to help avoid symptoms or cope with them when they do happen.
Ways to avoid triggers may include:
People who have symptoms of IBD (persistent diarrhea, abdominal pain, or bloody stools) should see a healthcare provider for an evaluation. A diagnosis of IBD can take time, so it’s important not to delay seeking care.
Contact your healthcare provider when signs or symptoms worsen or return after remission. There may be a need for testing to determine the cause and adjust your treatment plan.
In most cases, IBD is not considered a life-threatening or fatal condition. However, some signs and symptoms require care in the emergency department. These may include:
