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
