Fatigue has been called the most under-managed problem for people with inflammatory bowel disease. Fatigue is the second most common symptom of Crohn Disease. It affects most people with active Crohn’s disease, as well as many people in remission. Fatigue is an ongoing and overwhelming sense of tiredness, weakness, or exhaustion. It interferes with your ability to do physical or mental work. Getting enough sleep or rest does not cure fatigue. Some studies show that fatigue is more bothersome than bowel symptoms. Fatigue can decrease your quality of life and increase disability. It can affect your job, family life, social activities, and emotions.

 How is fatigue treated?
Some people feel less fatigue once they start treatment for Crohn’s disease. In other inflammatory conditions, biologic medications reduce fatigue. One theory is that the intestinal lining needs to heal for the fatigue to improve. People in remission from symptoms often still have inflammation in the digestive tract.

If you have iron-deficiency Anemia, your health care provider probably will recommend an iron supplement. Iron supplements can be taken by mouth or intravenously. Iron supplements may not be enough for severe anemia. Your provider may prescribe a erythropoiesis stimulating agent. These medications cause your bone marrow to make more red blood cells.

You may find some general recommendations for fatigue helpful. Perhaps surprisingly, moderate exercise can be better than rest. An example of moderate exercise is 30 minutes of walking. Doing your best to maintain your relationships with friends and family may help with fatigue. You may find that returning to work-particularly if you can have flexible hours-can be energizing. Of course, if your Crohn’s Disease is very severe, these activities may be difficult or impossible, which can be very frustrating.

Extra hours of sleep may not make you feel more rested. However, improving the quality of sleep you get might. Tips for improving sleep quality include:
-- Avoid caffeine, nicotine, chocolate, and alcohol before bed.
-- Increase your exposure to natural, bright light during the day.
-- Exercise early in the day.
-- Limit naps to less than 1 hour in the early afternoon.
-- Eat your last meal several hours before bed.
-- Make sure that your sleep environment and bedtime routine are pleasant and relaxing.
-- Limit noise, television, and other screens before bed.
-- Keep extra pajamas and a fresh pillowcase nearby and sleep on a towel, if night sweats are a problem.