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Fatigue and IBD

Aug 12, 2020
Fatigue and IBD

Fatigue is common in many chronic inflammatory conditions such as inflammatory bowel disease (IBD), rheumatoid arthritis, multiple sclerosis, etc. It has many causes and is a cause of frustration. Fatigue is a prevalent complaint in 50 - 75% of IBD patients.

Screening for IBD Fatigue: The most valid and reliable scale to assess fatigue that is specific for IBD patients is the IBD-fatigue (IBD-F) patient self assessment scale.

What are the factors contributing to fatigue in IBD?

IBD Flare: It’s crucial to rule out flares as a cause of IBD fatigue.  IBD flares should be ruled out by objective measures :

  • Biomarkers CRP/Fecal calprotectin
  • Endoscopy

Anemia: Iron deficiency anemia can be due to chronic gastrointestinal bleeding, poor nutrient intake or active flares.

Anemia can also be due to folate deficiency caused by methotrexate or decreased intake/absorption.

B12 deficiency can also be due to ileal disease/resection or SIBO (with folate).

Associated Diseases: liver disease, thyroid disease, celiac, low testosterone, primary biliary cirrhosis, primary sclerosing cholangitis, endocrine disorders.

Medication side effect: steroids, AZA/6-MP/MTX SE, Narcotics, antidepressants, cannabis.

Mineral/Vitamin Deficiency: magnesium, zinc.

Emotional health: sleeping disorders, depression, anxiety, mood.

Nutritional Deficiency: Vitamin D, etc

 

References

https://pubmed.ncbi.nlm.nih.gov/28749985/

https://pubmed.ncbi.nlm.nih.gov/20456309/

https://doi.org/10.1016/S2352-3026(17)30182-5

https://ncbi.nlm.nih.gov/pmc/articles/PMC5439135

https://link.springer.com/article/10.1007/s12325-019-01151-w

Medically Reviewed by O Adegbola, MD PhD


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