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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