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Crohn's disease symptom: Is fatigue common?

By Mayo Clinic staff

Original Article:  http://www.mayoclinic.com/health/crohns-disease/AN01434
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    Michael F. Picco, M.D.

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Question

Crohn's disease symptom: Is fatigue common?

Is fatigue a common Crohn's disease symptom? What can be done about it?

Answer

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.

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References
  1. About Crohn's disease. Crohn's & Colitis Foundation of America. http://www.ccfa.org/info/about/crohns. Accessed Dec. 10, 2012.
  2. Crohn's disease. National Digestive Diseases Information Clearinghouse (NDDIC). http://digestive.niddk.nih.gov/ddiseases/pubs/crohns/index.htm. Accessed Dec. 10, 2012.
  3. 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.
  4. 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.
  5. Graff LA, et al. A population-based study of fatigue and sleep difficulties in inflammatory bowel disease. Inflammatory Bowel Disease. 2011;17:1882.
  6. Vogelaar L, et al. Determinants of fatigue in Crohn's disease patients. European Journal of Gastroenterology & Hepatology. 2013;25:246.
  7. 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.
  8. 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.
  9. Rogler G, et al. Gastrointestinal and liver adverse effects of drugs used for treating IBD. Best Practice & Research Clinical Gastroenterology. 2010;24:157.
  10. Picco MF (expert opinion). Mayo Clinic, Jacksonville, Fla. Dec. 18, 2012.
AN01434 Jan. 22, 2013

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