Dont Forget To Mention How Tired You Feel
With various factors at play, youll need to try a multi-pronged approach to fight fatigue. First, dont forget to address your fatigue levels with your doctor at every appointment. With other possible symptoms to discuss it might not come upso be sure to mention your energy levels. Your doctor can then review your medications to see if any might be draining you. Some medications used to treat UC can cause fatigue either directly or indirectly by disrupting sleep. Other medications that alter the immune system have also been reported to make people feel tired, per the Arthritis Foundation.
How Is Crohns Disease Diagnosed
Most people with Crohns first see a healthcare provider because of ongoing diarrhea, belly cramping or unexplained weight loss. If you have a child who has been experiencing the symptoms of Crohns disease, reach out to your pediatrician.
To find the cause of your symptoms, your healthcare provider may order one or more of these tests:
- Blood test: A blood test checks for high numbers of white blood cells that may indicate inflammation or infection. The test also checks for low red blood cell count, or anemia. Approximately one in three people with Crohns disease have anemia.
- Stool test: This test looks at a sample of your stool to check for bacteria or parasites. It can rule out infections that cause chronic diarrhea.
- Colonoscopy: During a colonoscopy, your doctor uses an endoscope to examine the inside of your colon. Your doctor may take a tissue sample from the colon to test for signs of inflammation.
- Computed tomography scan: A CT scan creates images of the digestive tract. It tells your healthcare provider how severe the intestinal inflammation is.
- Upper gastrointestinal endoscopy: Your doctor threads a long, thin tube called an endoscope through your mouth and into your throat. An attached camera allows your doctor to see inside. During an upper endoscopy, your doctor may also take tissue samples.
- Upper gastrointestinal exam: X-ray images used during an upper GI exam allow your doctor to watch as a swallowed barium liquid moves through your digestive tract.
Avoid Sugar To Help Curb Inflammation
Refined sugar is not your friend if you have UC, according to Eleanor Baker, M.S., a registered dietician in Melbourne, FL. Diets high in added sugar contribute to a spike in blood glucose that can result in a short-term increase in energy, and then a drop in energy levels as the body strives to keep up with the excessive intake of sugar. Ms. Baker recommends eating foods with naturally occurring sugars and whole grains to provide you with a steady release of energy without the undesirable crash later. For a healthy treat try these low-sugar dessert recipes for people with UC.
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Prevalence And Score Of Fatigue
The prevalence of fatigue in patients with UC, defined as a FSS score> 4, was 61.8% in the total study population. The prevalence of fatigue in patients with active disease was 68.2%, which was remarkably high compared with those in remission . The score of MFI showed a positive correlation with FSS score . The median FSS score of UC patients was 4.4. The median total score of MFI was 61 . The scores of different MFI domains were general fatigue: 13 physical fatigue 13 mental fatigue11 reduced activity 11 and reduced motivation 12 .
Fatigue score in ulcerative colitis patients. A Correlation between FSS score and MFI score in patients with UC. Pearson r=0.687 P< 0.0001. B The fatigue score of different MFI domains
Don’t Ignore Nutritional Deficiencies
Its important to get assessed for nutritional deficiencies and then treat them if they are present, says Dr. Ananthakrishnan. Some of the most common nutritional deficiencies include iron, B12, vitamin D, vitamin K, folic acid, selenium, zinc, vitamin B6, and vitamin B1. There are many nutrient-rich foods that can help alleviate various deficiencies from UC, but flares or other complications may make it difficult to get enough nutrients from food alone. Your medical team may recommend supplementing your diet with vitamins or minerals.
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When To Get Medical Advice
You should see a GP as soon as possible if you have symptoms of ulcerative colitis and you have not been diagnosed with the condition.
They can arrange blood or stool sample tests to help determine what may be causing your symptoms.
If necessary, they can refer you to hospital for further tests.
If you have been diagnosed with ulcerative colitis and think you may be having a severe flare-up, contact a GP or your care team for advice.
You may need to be admitted to hospital.
If you cannot contact your GP or care team, call NHS 111 or contact your local out-of-hours service.
You Begin Doing The Things You Used To Do
You will know the treatment and medication are working when you start doing the things you enjoyed doing before. For instance, going out or taking on extra activities. As long as you are maintaining your treatment plan and avoiding triggers, there should be no problem with doing the things you enjoyed doing before.
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Can Elimination Diets Cure It
Up to 60% of IBD patients have tried an elimination diet to relieve ulcerative colitis symptoms .
Unfortunately, the only known cure is total surgical removal of the colon and rectum .
There is no scientific proof that any diet can cause remission on its own. However, limited evidence suggests that certain diets can greatly improve comfort and quality of life.
The impact of diet on inflammatory bowel disease. Click to enlarge. Image .
What Is The Prognosis For People With Crohns Disease
Most people with Crohns disease enjoy healthy, active lives. While there isnt a cure for Crohns disease, treatments and lifestyle changes can keep the disease in remission and prevent complications.
Lifestyle changes can include changes to your diet. People with Crohns disease often need to adapt their diets so that they get enough calories each day. Lactose intolerance can also be an issue for those with Crohns disease. You may need to avoid certain dairy products if you find that youre having issues with this dietary intolerance. You should also avoid smoking if you have Crohns disease. Smoking can only make your condition worse.
Your healthcare provider might recommend you receive preventative colonoscopies after youre diagnosed with Crohns disease. Talk to your provider about how often you should have colonoscopies and what your risks are for other medical conditions.
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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.
2.2.1. Inflammation
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.
2.2.2. Anaemia
2.2.3. Nutrition
2.2.4. Sleep disturbance
2.2.5. Emotional distress
2.2.6. Pain
2.2.7. Medication side effects
2.2.8. Activity level
2.2.9. Comorbidities
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.
What Are The Symptoms Of Ulcerative Colitis
Ulcerative colitis symptoms often get worse over time. In the beginning, you may notice:
- Diarrhea or urgent bowel movements.
- Abdominal cramping.
- Liver disease.
- Loss of fluids and nutrients.
Symptoms are similar in pediatric ulcerative colitis and may also include delayed or poor growth. Some ulcerative colitis symptoms in children can mimic other conditions, so it is important to report all symptoms to your pediatrician.
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Theme : Phenomenon Of Fatigue As Perceived By Hcps
5.1.1 Sub-theme 1: description of fatigue
The study participants reported problems describing and understanding fatigue. They perceived fatigue as âsuch a complicated and complex thingâ . Respondents suggested that the hidden, subjective and non-specific nature of fatigue makes it more difficult for patients to talk about it. âYou can talk about your broken arm or your heart surgery and things like that and explain to your colleagues, your family or your friends what’s happened to you but it’s difficult to explain fatigueâ . In their attempt to understand how fatigue feels to people with IBD, HCPs compared it to their own feelings of tiredness. âWe are all tired. What I would personally think fatigue is, is an extension, a worsening of thatâ .
All twenty participants talked about the language that patients use to describe their feeling of fatigue and the challenge that HCPs face in gauging the meaning and the severity of the problem. Words recalled by respondents as used by patients when reporting fatigue to HCPs are summarised in . The terms seemed to refer to both the concept of fatigue and the impact that fatigue has on patients. The respondents were in agreement that patients tend to use generic, everyday language rather than the word âfatigueâ.
5.1.2 Sub-theme 2: contributors to fatigue
5.1.3 Sub-theme 3: prevalence and awareness of fatigue
5.1.4 Sub-theme 4: types of fatigue
Why Patients Stop Uc Treatment
People stop taking their ulcerative colitis medications for a number of reasons, says Phanijphand.
One of the leading reasons is the steep cost of the drugs. The out-of-pocket cost for prescription medicines can run over $2,000 per year, while the cost of UC care in general can run from roughly $15,000 to $25,000 per year, according to a study published in Inflammatory Bowel Diseases in January 2020.
The study also found that patients using biologics had the highest costs. Treating UC with corticosteroids had higher costs than with nonsteroidal anti-inflammatory drugs, but the latter groups costs rose more over time.
Also, when a person feels better, they may decide they no longer need UC medicine.
âSome patients think that once their symptoms are gone, they can stop taking their meds,â Phanijphand says. âThey believe theyâre cured or that they may have been misdiagnosed.â
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Not Talking To Your Doctor Before Starting A New Diet Or Taking Supplements
Are you considering trying a new way of eating or starting a new regimen of vitamins and minerals? While it may be just fine , Dr. Hagan says its important to run it by your doctor first. I love it when my patients come to me and say, Hey, my girlfriend told me this supplement is great for a healthy immune system and I want to take it, she says. This gives me a chance to take a look at the supplement, along with the other medications that the patient is on, so I can make sure nothing will interact.
As for diet changes, most foods are OK for colitis patients because colitis mainly affects the large intestine. By the time food gets there, youve gotten what you need out of your food and your body is just eliminating the rest, Hagan says. That said, its still a good idea to clue your doctor into any big changes in your go-to diet. For example, if youre taking an immunosuppressant drug, youll want to avoid eating anything unpasteurized, says Dr. Hagan. Think of it as a great opportunity for you and your doctor to touch base and make sure your lifestyle choices are supporting your treatment plan.
What Ulcerative Colitis Fatigue Feels Like
Fatigue is beyond just a passing feeling of being tired, explains Dr. Katkov. People with ulcerative colitis can experience malaise, a profound kind of fatigue that makes it difficult to carry out normal activities, he says.
Tina Haupert, a nutrition coach living in the South Shore of Massachusetts who was diagnosed with ulcerative colitis in 2011, agrees. Before addressing her UC fatigue with dietary changes and exercise, she pretty much always felt tired.
According to research by the British organization Crohns and Colitis UK, people with IBD often describe their tiredness with words such as: brain fog, zombie mode, feeling woozy or fuzzy, completely wiped out, and overwhelming heaviness.
The group also found that IBD fatigue tends to be unpredictable it can come on suddenly, without warning, and vary from day to day. It can also affect memory and concentration, interfere with work, make it harder to exercise and socialize, and take a hefty emotional toll, leading to reduced confidence and depression, they report.
Experts agree that making sure fatigue doesnt interfere with quality of life, the ability to work, and the capacity to have a normal social life is central to the goal of treating a chronic condition like ulcerative colitis. We dont want to settle for a lower quality of life than what can be achieved with aggressive treatment, Katkov says.
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Q: What Are The Limitations Of Current Therapies For Ulcerative Colitis
A: Conventional therapies such as aminosalicylates are modestly effective in patients with moderate, but not severe, disease. Glucocorticoids have been associated with adverse events and long-term adverse health consequences and are not recommended as maintenance therapy. Newer agents, including biologic drugs and Janus kinase inhibitors, are not effective in all patients or can lose efficacy with long-term use, and they have been associated with infections, infusion reactions, and cancers. Thus, the need remains for new oral treatments for ulcerative colitis that are safe and glucocorticoid-sparing and that have durable efficacy.
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Eat For Maximum Energy
Diet may play a role in causing UC fatigueespecially if youre not eating a balanced and broad diet, says Dr. Ananthakrishnan . Consuming low FODMAP foods can also help so, too, can avoiding seeds, whole wheats, and lactose foods. While there are several specialized diets that may be helpful for some, no one plan has been proven to prevent or control UC, per the Crohns & Colitis Foundation. Your medical team may recommend a particular diet based on your symptoms and what foods youre best able to tolerate.
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Limitations Of The Study
Qualitative studies typically use a small sample size, aiming for breadth and depth on a topic where little is known. It does not aim to be numerically representative of the studied population, but rather reflects the range of professionals involved in IBD care. The data only reflects the experience and views held by the participants and the study is UK based. Due to recruitment difficulties the final composition of the group was less balanced than originally intended, with IBD nurses dominating the group.
What Complications Are Associated With Ulcerative Colitis
Yes. There are some complications related to ulcerative colitis. Possible complications include:
- Severe bleeding
- Toxic megacolon
- Liver disease
People with ulcerative colitis are also at increased risk of developing colon cancer. The risk of colon cancer is related to the length of time since you were diagnosed and how much of your colon is affected by inflammation. However, a regular examination by your doctor and colorectal cancer screening tests can help to reduce the risk of cancer and detect problems early.
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Can I Stop Taking My Meds In Deep Remission
In a word: no. The key to remaining in remission is sticking to your recommended treatment plan. A study published in PLoS One found that people in remission who stopped taking their meds were five times more likely to relapse. Treatments that may help achieve or maintain UC remission include aminosalicylates, drugs that reduce inflammation in the lining of the colon, and immunomodulators, meds that modify the immune system in order to decrease the bodys inflammatory response. All treatments come with potential side effects, and it can take time to find the one that works best for you.
How Does Ulcerative Colitis Affect Your Life
As a relapsing and remitting disease you can expect to have periods where you are well and times when you are unwell from your ulcerative colitis. When your UC symptoms get worse this is known as a flare up and when there is no sign of your UC being active this is called remission.
It isnt yet known exactly what can cause you to have an ulcerative colitis flare up and it may feel like the symptoms come on very suddenly with little warning. Unfortunately due to the unpredictable nature of ulcerative colitis it does mean that you may live with some uncertainty when it comes to your day-to-day life and planning ahead. It can be difficult for other people to understand this so you may want to talk to your family, close friends and workplace about how it can affect you and so that you can come up with some plans for childcare, work etc in case you do become unwell at short notice. You could also consider taking out some specialist travel insurance for people with ulcerative colitis. This will probably be more expensive than standard travel insurance but will give you peace of mind in case you need to cancel holidays and trips due to your UC.
Its important that a treatment is found to get your ulcerative colitis under control and into remission so that you can live a better quality of life, but also to prevent some complications which can arise out of having active UC. You can find out more about some of these complications in this article: How serious is ulcerative colitis?
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