Do you sometimes feel like a walking zombie? Drained, with an overwhelming sense of tiredness, lack of energy, or feeling exhausted even after you’ve had a full night sleep?

You are not alone.

When you have Crohn’s disease or ulcerative colitis (IBD), fatigue can feel physical, mental, or both! You may feel like you’ve suddenly “hit a wall” and that’s a very common feeling.

Fatigue can mean a few different things, it can describe feeling tired, tired after waking up or feeling so tired it’s difficult to pay attention. The first two tend to be the most common descriptions shared by kids and teens with IBD.

Researchers do know that fatigue can affect you physically, emotionally, mentally, socially and impact your quality of life. [1]Fatigue is also reported by kids and teens to be a distressing symptom because it’s unpredictable and can vary from one day to the next.

Why do I feel this way?

There are a few factors that have been linked to fatigue in Crohn’s disease and ulcerative colitis. They include:

Inflammation 
If you are in a flare, fatigue might come from your body’s response to inflammation.
Several studies have shown a relationship between IBD disease activity and fatigue. Teens with active IBD tend to experience more fatigue than teens with IBD in remission, and teens in remission have fatigue levels higher than teens ingood general health.[2]

Nutritional deficiencies
Vitamin and nutrient deficiencies in those with IBD may be caused by diarrhea or a loss of appetite, which can leave you feeling worn out or tired.

Pain
Pain is very common and dealing with pain can be very tiring. If you are experiencing pain, it may be contributing your fatigue, causing poor sleep, reduced physical activity, emotional and psychological distress. Speak to your doctor to identify different ways to manage pain.

Anemia
Anemia can be common for those with IBD. Low iron levels can make you feel tired and affect energy levels. It’s important to ask your Gi about your iron levels and take an iron supplement if recommended by your doctor.

Medication
Some medications used to manage IBD inflammation may cause side effects like fatigue. Your Gi may be able to suggest different ways/times to take your medication so it won’t interfere with your sleep.

Before you settle 100% on fatigue being the cause of your exhaustion and tiredness, let’s explore one possible culprit, sleep. You might think fatigue or sleepiness are the same, but they’re not.

We know fatigue refers to those feelings of tiredness or exhaustion usually caused by illness or physical activity – sleepiness is different. Sleepiness is when you feel drowsy and sluggish, and it’s hard to keep your eyes open.

Sleep is essential for both mental and physical health.

On average, children between 6-12 years old need 9-12 hours of sleep and teenagers between 13-18 years old need 8-10 hours to function best.[3] Sleep is food for your developing brain. It fuels your body, helps you grow, plus sleep can help reduce anxiety.

If you think you might need more sleep, try to:

  • Make sleep a priority, keep a sleep diary
  • Have a nap when you get home from school and on weekends
  • Avoid food and drinks with caffeine in the evening
  • Keep a consistent week-day sleep routine
  • Avoid exercising a few hours before bedtime
  • Shut down the TV and digital devices an hour before bed
  • Have a bath/shower before bed

If you’ve tried changing your sleep habits, and you continue to feel tired and exhausted, fatigue just might be the cause. Remember, everyone is different – If you feel fatigue is affecting how you function during the day or you know fatigue is at play, speak to your gastroenterologist.

Your IBD healthcare team can help you find strategies to manage fatigue best and get you back to doing the activities that make you happy.

To read more articles on pediatric Crohn’s and UC, visit the latest edition of our magazine, You, Me and IBD.

Contributor


Dr. Mary Zachos contributed to the content and review of this article for accuracy and balance. We thank Dr. Zachos for her time and contribution to our magazine. Dr Mary Zachos, MD, FRCPC, is a Pediatric Gastroenterologist in the Department of Hepatology and Nutrition, GI Program Director and Associate Clinical Professor at McMaster Children’s Hospital in Hamilton, Ontario.

[1] van Langenberg DR, Gibson PR. Systematic review: fatigue in inflammatory bowel disease. Aliment Pharmacol Ther. 2010;32:131–143. [PubMed] [Google Scholar]