- With Mayo Clinic gastroenterologist
Michael F. Picco, M.D.read biographyclose window
Michael F. Picco, M.D.Michael F. Picco, M.D.
Dr. Michael Picco has been with Mayo Clinic since 1999. He is board certified in internal medicine and gastroenterology. Dr. Picco is an assistant professor of medicine at College of Medicine, Mayo Clinic, and a consultant in gastroenterology at Mayo Clinic in Florida.
He has authored numerous publications in the area of gastroenterology, including original research, editorials and textbook chapters. He works with a team of gastroenterologists that takes care of complex gastrointestinal conditions and has a particular interest in diarrheal illnesses and inflammatory bowel diseases (ulcerative colitis and Crohn's disease). He is also active in medical education in training new gastroenterologist and internists.
"Mayo Clinic's website is an invaluable resource for patients and their families," Dr. Picco said. "Informed patients are better able to participate in their own health care. A patient's participation is vital to the treatment of his or her disease. I hope to assist in helping patients understand their digestive problems and current treatments that are offered. This will allow for better communication between patients, their physicians and other health care professionals."
Dr. Picco serves as a reviewer of new research for several medical journals in the area of gastroenterology and is an active member of the American Gastroenterological Association, American College of Gastroenterology and the Crohn's & Colitis Foundation of America. He serves on numerous committees that address physician training, research and clinical practice in gastroenterology, both at Mayo Clinic and at the national level.
"Patients need to know about their disease, what to expect, the latest treatments and side effects so that they can make informed decisions about their health care. Gastrointestinal disease affects not only patients but also their families. My goal is to assure that our website provides accurate, reliable information and resources for patients. We must always provide the latest, most cutting-edge information to assist patients in dealing with their medical problems," Dr. Picco said.
- Crohn's disease symptom: Is fatigue common?
Tests and diagnosis (1)
- Splitting doses: A good strategy for colonoscopy preparation?
Crohn's disease symptom: Is fatigue common?
Is fatigue a common Crohn's disease symptom? What can be done about it?
from Michael F. Picco, M.D.
Fatigue is an all too common symptom of Crohn's disease. In one study, about three-quarters of people with active disease reported high levels of fatigue. Other studies of people whose disease was in remission found that fatigue continued to be a problem for 30 to 40 percent of them.
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 disease — pain, anxiety, depression, difficulty sleeping — also contribute to feelings of fatigue.
What can be done about it? Fatigue is a knotty problem with no easy answer. Here are a few ideas:
- Get your disease under control. People whose disease is in remission have fewer complaints about fatigue. Medications that target inflammation, such as biologic therapies (adalimumab, certolizumab, infliximab) and immunomodulators (azathioprine, mercaptopurine, methotrexate), help many people feel better, with less fatigue.
- Treat anemia. A shortage of red blood cells is a common problem among people with Crohn's disease. It can contribute to low energy and fatigue.
- Talk to your doctor about your medications. Certain medications used to treat Crohn's disease, such as corticosteroids (prednisone), can lead to fatigue — either directly or by interfering with sleep.
- Seek psychological therapy. Consider talking to a doctor or a counselor about ways to manage fatigue and other psychological factors that can impact fatigue, including stress, anxiety and depression.
To fight fatigue, it's also helpful to include physical activity in your daily routine, eat healthy foods and get adequate 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.Next question
Splitting doses: A good strategy for colonoscopy preparation?
- About Crohn's disease. Crohn's & Colitis Foundation of America. http://www.ccfa.org/info/about/crohns. Accessed Dec. 10, 2012.
- Crohn's disease. National Digestive Diseases Information Clearinghouse (NDDIC). http://digestive.niddk.nih.gov/ddiseases/pubs/crohns/index.htm. Accessed Dec. 10, 2012.
- Jelsness-Jorgensen LP, et al. Chronic fatigue is more prevalent in patients with inflammatory bowel disease than in healthy controls. Inflammatory Bowel Disease. 2011;17:1564.
- Minderhoud IM, et al. Crohn's disease, fatigue, and infliximab: Is there a role for cytokines in the pathogenesis of fatigue? World Journal of Gastroenterology. 2007;13:2089.
- Graff LA, et al. A population-based study of fatigue and sleep difficulties in inflammatory bowel disease. Inflammatory Bowel Disease. 2011;17:1882.
- Vogelaar L, et al. Determinants of fatigue in Crohn's disease patients. European Journal of Gastroenterology & Hepatology. 2013;25:246.
- Casellas F, et al. Mucosal healing restores normal health and quality of life in patients with inflammatory bowel disease. European Journal of Gastroenterology & Hepatology. 2012;24:762.
- Vogelaar L, et al. The impact of biologics on health-related quality of life in patients with inflammatory bowel disease. Journal of Clinical and Experimental Gastroenterology. 2009;2:101.
- Rogler G, et al. Gastrointestinal and liver adverse effects of drugs used for treating IBD. Best Practice & Research Clinical Gastroenterology. 2010;24:157.
- Picco MF (expert opinion). Mayo Clinic, Jacksonville, Fla. Dec. 18, 2012.