Five Types Of Disease
There are five types of Crohns disease according to the Crohns & Colitis Foundation. These are ileocolitis, ileitis, gastroduodenal Crohns disease, jejunoileitis and Crohns colitis. Some medical centers recognize a sixth type called perianal disease.
Each type affects a different part of the digestive tract and causes different symptoms and complications.
Appetite Loss From Medication Use
Drugs that are used for the treatment of IBD are another factor in decreased appetite. Immunomodulators such as Purinethol and Prograf are associated with appetite loss as a common side effect, as are other IBD medications. Although corticosteroids may increase appetite, they can also cause a decrease in appetite as a side effect.
Reasons You May Be Experiencing Crohns
Quality sleep is important for keeping Crohns disease under control. A study published in February 2020 in Scientific Reports found people with active Crohns disease reported getting less sleep than people without the disease or those whose disease was in remission. Another study, published in December 2019 in the journal Inflammatory Bowel Diseases, observed that sleep disturbances can lead to worse outcomes for Crohns patients and that poor sleep quality is associated with disease activity.
You may also have fatigue from a variety of sleep- and non-sleep-related issues, including:
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Why Does Crohns Disease Cause Fatigue
Fatigue is one of the most common symptoms of Crohns Disease, and there are several reasons why it occurs.The chemical signals that are produced when the body becomes inflamed impact the brain. This causes a lack of energy and fatigue. You may also be experiencing anaemia, which is known to cause extreme tiredness.Due to the digestive troubles the condition causes, it can also lead to a nutritional deficiency. This in turn will cause fatigue. Other causes include issues with sleep, arthritis, and medications.
How Is Fatigue Evaluated
Many different scales and questionnaires are used to measure fatigue. No single standard exists.3 One questionnaire about fatigue with inflammatory bowel disease was developed and scientifically validated in the United Kingdom and is available online. You or your provider may be interested in using this questionnaire to track changes over time.1
Your health care provider may do laboratory tests. It is common to check for anemia, active inflammation, thyroid function, or pregnancy.10 Your provider may ask questions about sleep hygiene, medications, and exercise.
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Get A Handle On Stress
Real talk: Its stressful to have a chronic disease. The unpredictability and nature of Crohns can make it even more anxiety-provoking. Its hard when you have a disease thats hard for other people to understand and its very personal, so that can create a lot of extra things to try to navigate, Dr. Streett says.
Many people say that stress is a trigger for their IBD flaresand research backs that up. A review published in Frontiers in Pediatrics noted that clinical and experimental studies suggest that stress exacerbates IBD and, on the flipside, evidence shows an increasing incidence of mental health conditions like depression and anxiety in people with IBD. This appears to be the case in both children and adults with IBD. While the mechanism isnt fully understood, research is being done to explore how the gut and brain communicate, and how the immune system factors into it all.
Managing stress is easier said than done. Dr. Streett suggests minimizing the time you spend doom-scrolling on social media and trying to do things that are relaxing and regenerative, like meditation and exercise. Those things help us manage worry and anxiety and help us sleep better, she says. Seeking out support from family, friends, and other Crohns warriors can help.
You can also search for support groups near you and digital groups on the Crohns and Colitis Foundation website.
Loss Of Appetite And Ibd
Decreased appetite and reduced food intake in people with IBD are often the result of digestive tract symptoms, side effects from medications, and inflammation. A loss of appetite may lead to weight loss, which occurs in as many as 70 percent to 80 percent of people hospitalized with IBD and in 20 percent to 40 percent of people with IBD who are treated on an outpatient basis.
MyCrohnsAndColitisTeam members frequently discuss their experiences with reduced appetite. I have no appetite lately. I even struggled to eat my favorite dessert last night, a member wrote. Another said, Im feeling very exhausted from work and barely have an appetite.
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Improving Appetite With Diet
Research shows that diet can have a significant impact on symptoms for people with IBD, including appetite and maintenance of a healthy weight. A new area of research called immunonutrition is examining the role of vitamins and minerals in gut inflammation.
Some of the findings of immunonutrition suggest that dietary factors may be beneficial to gut health, appetite, and absorption of nutrients for some people with IBD. These factors include:
- Probiotic foods or supplements
- Avoiding or reducing processed foods and refined carbohydrates and sugars
- Avoiding or reducing animal protein and dairy
- An anti-inflammatory Mediterranean diet high in fruits, vegetables, olive oil, and oily fish,
According to the Crohns & Colitis Foundation, to maintain a healthy level of calories, people with IBD may benefit from:
- Small, frequent meals
- Adding avocado or oils to meals
- Snacks with fruit or nut butter
It takes a while, but you will get your appetite back, a MyCrohnsAndColitisTeam member said. Start with small meals, then gradually build up. Another member wrote, Sugar is the devil! When I dont consume any processed sugar it makes a huge difference.
How To Get That Energy Back
So what can you do to help restore or improve your energy? It comes down to your specialists determining the exact cause of your exhaustion. Your doctor will likely order a variety of blood work to check for anemia, malnutrition, active inflammation, and a metabolic panel for possible problems. In the meantime, other factors that may cause fatigue should be investigated, such as recent changes in your life, new symptoms or any medication changes. Medications can easily change sleeping habits, especially steroids that are commonly used for treating Crohns flares.
Communicating with your doctors is very important so they can closely to monitor your disease and help. Hopefully, with their help and proper treatment, your energy levels will return and you can more easily catch more Zzzs.
Note: IBD News Today is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those of IBD News Today, or its parent company, BioNews Services, and are intended to spark discussion about issues pertaining to IBD.
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Diarrhea And Other Symptoms
Symptoms of Crohns range from mild to very severe. For example, people with mild disease may have abdominal pain or frequent diarrhea, but can eat normally and dont have weight loss. People with very severe disease have high fevers, persistent vomiting, intestinal obstructions or abscesses and severe weight loss.
While Crohns affects the digestive tract, it may also cause extraintestinal symptoms. These symptoms affect parts of the body outside the digestive tract, such as the eyes, joints and skin.
Symptoms of Crohns include:
- Abdominal tenderness and pain
- Weight loss
Treat Underlying Anemia And Other Conditions
Anemia is a big issue that we have realized we have been under treating, Dr. Streett says. Anemia in IBD is often treated with IV iron infusions. Simply adding more iron to your diet wont cut itif youre severely lacking iron, you wouldnt realistically be able to consume enough to make up for it, and absorption issues complicate things even further.
Oral iron supplements may be given if youre in remission or dont have active inflammation in the intestine, but people with active Crohns may not be able to tolerate the supplements, so doctors often opt for infusions. Infusions also are more effective, since they don’t rely on absorption in the gut. The number of iron infusions you need will depend on the severity of your anemia and whether your Crohns is still actively impacting iron absorption or not.
Your doctor may also refer you to a hematologist to treat you. Of course, youll also need to get the underlying Crohns under control to prevent anemia from happening again.
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Levels Of Fatigue In Ibd Patients
The proportion of IBD patients with active disease that experienced moderate or severe fatigue according to BFI and MFI overall questionnaires was 82.9 and 80.0%, respectively. In contrast but still clinically important, 39.5 and 44.2% of the quiescent disease IBD patients experienced moderate or severe fatigue according to BFI and MFI overall questionnaires, respectively.
Based on BFI and all MFI dimension results, 59.283.7% of active CD and 14.371.4% of remission CD patients reported moderate to severe fatigue 42.995.2% of active UC and 22.754.5% of remission UC patients reported moderate to severe fatigue .
Comparison of population percentages experiencing moderate and severe fatigue and severe fatigue .
There was a large variation between the different fatigue dimensions in all patient categories, highlighting the multifactorial nature of this symptom. The most prevalent type of moderate and severe fatigue in all studied patients was General Fatigue . The least prevalent was Mental Fatigue in CD and UC active disease , and Reduced Motivation and Reduced Activity in CD and UC in remission, respectively .
There was a larger difference between severe fatigue prevalence in disease in remission comparing to active disease than in moderate fatigue . There was little difference between Reduced Activity, Mental Fatigue and Physical Fatigue prevalence between active disease patients and patients in remission.
How Crohns Causes Fatigue
While we think of Crohns as a disorder that affects the GI tract, its actually a systemic disorder, Dr. Streett says. Meaning that the gut is inflamed, but theres also inflammation throughout the entire body, which is why fatigue is so common. Chronic inflammation is a drain on your energy, Dr. Streett says. Your body is constantly working to fight off something it considers a threat. Its similar to feeling tired when you have the flu or another viral infection. The body is trying to function but its being drained by this chronic inflammation, she says.
Beyond inflammation, Crohns can cause some other health complications that contribute to fatigue. One big one: anemia. When people have sores in the gut, they can lose protein and blood over time, Dr. Streett explains. The presence of chronic inflammation in itself can also worsen production of blood cells. This loss of blood and blood cells can cause iron-deficiency anemia. Guess what one of the biggest symptoms of anemia is? Yup, fatigue.
The best thing you can do to prevent Crohns fatigue and feel better when it hits is to take care of your body. First, you have to be on a Crohns treatment regimen that works well for you, then you can work on fatigue-fighting lifestyle changes to give you an extra boost.
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Tips To Reduce Crohns Fatigue
If your fatigue is linked to a Crohns disease flare-up, its essential to discuss your treatment options with your doctor. These may include changing the type or dose of medication youre taking.
And regardless of whether youre having a flare-up, you may want to ask your doctor for a blood test to check your iron and vitamin B12 levels. If youre deficient in either, they may recommend working with a nutritionist to adjust your diet and adding supplements or injections.
No matter whats causing your fatigue, its important to stay active, Bloomfeld says. The January 2016 study review suggests that exercise can help reduce IBD-related fatigue. Stretching, light exercise, and yoga are all good options to try, as they can help you build strength and boost energy. Its important to listen to your body, but you dont need to stay in bed because of fatigue, he says.
Exercise can also help reduce depression and stress, which are often linked to fatigue and tend to go hand in hand with chronic illnesses like Crohns disease, according to the Crohns and Colitis Foundation. Plus, working out may also boost your immune system, the organization says.
If you feel tired all the time, talk to your doctor to make sure youre doing everything you can to treat all of the symptoms related to your Crohns disease, including fatigue.
Additional reporting by Colleen de Bellefonds
Increased Appetite And Ibd
An increase in appetite and disordered eating can also occur in people with IBD. Binge eating, comfort eating, and impulse eating are all associated with IBD due to anxiety, depression, drug side effects, and factors associated with inflammation and the gut-brain axis. Flares also seem to affect appetite in some people.
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Science Behind Ibd And Sleep Disturbance
Sleep and the intricate relationship between sleep and IBD are a keen area of research interest because they are now thought to be an important environmental factor that may contribute to disease flares. There is good evidence about the link between sleep deprivation and the activation of the immune system, and the ability to mount an immune response . In a meta-analysis of experimental sleep deprivation studies, sleep disturbances were associated with increases in CRP and IL-6 . The largest studies that show a relationship between altered sleep patterns and inflammatory disorders are in shift workers. In one study, male electricians and male food and beverage industry workers had a statistically significant increased propensity for developing UC and CD, which was thought to be related to irregular hours and interrupted sleep patterns . Patients with IBD with poor sleep have increased rates of disease relapse, and lower sleep quality scores are predictive of subclinical histological inflammation and disease relapse at 6 months . In another study, patients with CD in remission had a twofold increased risk of disease recurrence at 6 months however, this was not seen in patients with UC . Ananthakrishnan et al. also found a higher incidence of UC in individuals with less than 6 h of sleep or more than 9 h of sleep .
Assessment Of Concurrent Symptoms
In order to select an optimal treatment strategy, assessment of concurrent symptoms is mandatory. Many factors are known to contribute to fatigue, such as inflammation, pain, emotional distress, sleep disturbance, anaemia, alterations in nutrition and overall nutritional status, and a diminished activity level. The presence of any of these conditions should be treated in accordance with practice guidelines and with referral to other care professionals as appropriate. Furthermore, medication side effects as well as alcohol and/or drug abuse should be taken into account, as should other comorbidities.
During periods of active gut inflammation, fatigue rates understandably increase. Fatigue, on the other hand, is a highly reported symptom and a major concern in IBD patients and fatigue can be a concealed indication of active disease. Disease activity should be ascertained by the usual clinical, radiological and endoscopic assessments in order to optimize treatment.
2.2.4. Sleep disturbance
2.2.5. Emotional distress
2.2.7. Medication side effects
2.2.8. Activity level
2.2.10. Substance abuse
Alcohol and/or drug abuse are associated with emotional distress, poor sleep quality and anxiety, and should always be assessed in the work-up of IBD-related fatigue.
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Is Fatigue A Common Crohn’s Disease Symptom What Can Be Done About It
Fatigue, an overwhelming sense of tiredness and lack of energy, is an all-too-common symptom of Crohn’s disease. Fatigue can have a major impact on people who have Crohn’s disease and ulcerative colitis, affecting their work, daily life and quality of life.
Besides direct effects from the disease, other factors that frequently affect people with Crohn’s diseasepain, anxiety, depression, difficulty sleepingalso contribute to fatigue.
What can be done about it? Fatigue is a tricky problem with no easy answer. Here are a few ideas:
To fight fatigue, include physical activity in your daily routine, eat healthy foods, drink plenty of fluids, especially water, and get enough sleep. Be sure to share your concerns about fatigue with your doctor so that he or she can help find ways to address this issue.
What Causes Crohns Disease
Theres no known cause of Crohns disease. Certain factors may increase your risk of developing the condition, including:
- Autoimmune disease: Bacteria in the digestive tract may cause the bodys immune system to attack your healthy cells.
- Genes: Inflammatory bowel disease often runs in families. If you have a parent, sibling or other family member with Crohns, you may be at an increased risk of also having it. There are several specific mutations to your genes that can predispose people to developing Crohns disease.
- Smoking: Cigarette smoking could as much as double your risk of Crohns disease.
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