IBD can affect more than just your gastrointestinal tract. Fatigue is a common debilitating symptom that can occur even when IBD is managed well.
Beyond my daily Crohn’s-related pains, I struggle with severe fatigue, which is not just your everyday “tired” feeling. No amount of sleep or rest can phase my fatigue. I go to bed exhausted. I wake up just as tired. I drag through the day. The smallest of tasks leave me feeling as if I ran a 5k that morning, but only after climbing Mount Fuji and walking the Appalachian Trail, too. My body feels worn out, even after small tasks like showering or driving to work. I tell ya, it’s exhausting.
Usually, I fight through with unmentionable amounts of caffeine — insert unsolicited and unwelcome chastising here — but my doctors think that’s fine, especially since it combats my migraines, too.
Many things can cause fatigue with Crohn’s disease or ulcerative colitis, including the following:
Steroids, such as prednisone, are notorious for causing insomnia and abnormal sleep patterns. I made the mistake of taking my steroids at night when I started them. After discussing insomnia and my daily routine with my doctors, we realized that I should take them in the morning to prevent a worsening of my insomnia symptoms.
Night sweats are the worst. I wake up sweaty and chilled, with urgency and tenesmus, all of which affect my sleep and my bowels.
Pain. All who have IBD know pain. Between abdominal pain, joint pain, harsh bowel movements, and inflammation, there are many ways that Crohn’s disease pain can occur, leading to fatigue for the patient. My fibromyalgia-related allodynia and Crohn’s disease pain both flare from fatigue, leading to even more fatigue.
Internal battles against inflammation don’t leave your body much time to “relax.” It is constantly stressing and laboring toward IBD management and body healing.
Anemia and vitamin deficiencies. When the body is missing essential nutrients and vitamins, the body reacts. A lack of iron (leading to anemia) is a major contributor to fatigue — blood loss is never good for the body.
Medications to help sleepless nights include melatonin and mirtazapine. Melatonin alone can be beneficial, but I take both, prescribed by my doctor. Melatonin is a supplement and mirtazapine is a prescription medication. I would recommend seeing your doctor and not self-prescribing, as withdrawal from mirtazapine can make symptoms worse, and people often underdose or overdose with melatonin.
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