Understanding IBD Fatigue: Why It Happens and What You Can Do

What to Know

• Fatigue is one of the most common and disruptive symptoms for people living with Crohn’s disease or ulcerative colitis.
• Inflammation, anemia, sleep problems, pain, malabsorption, and stress all contribute to low energy levels.
• Practical strategies like pacing activities, better sleep habits, gentle movement, and nutrient support can help manage fatigue.
• Biologic therapy may reduce fatigue by controlling inflammation and stabilizing IBD.
• Talk with your healthcare provider if fatigue worsens, persists, or interferes with daily life.

Why IBD Fatigue Happens

Everyone experiences tiredness, but IBD fatigue is different. It can feel overwhelming, constant, and disproportionate to your daily activity level. Many people with Crohn’s disease or ulcerative colitis describe it as a deep exhaustion that doesn’t improve with rest.

Nearly 80% of people with active IBD experience significant fatigue, making it one of the most common symptoms of the disease.

Fatigue happens because IBD affects the entire body, not just the digestive tract. Inflammation, nutrient deficiencies, poor sleep, pain, and emotional stress all drain energy.

Common Causes of IBD-Related Fatigue

1. Chronic Inflammation

Inflammation forces your immune system to work continuously, even outside of a flare. This constant activity consumes energy and can leave you physically and mentally drained.

2. Anemia

Anemia impairs the body’s ability to deliver oxygen, leading to fatigue, dizziness, and breathlessness. IBD increases the risk of anemia due to blood loss, iron deficiency, and impaired nutrient absorption, including B12 and folate.

3. Poor Sleep

Pain, nighttime bathroom trips, and anxiety can interrupt deep, restorative sleep. Without quality sleep, your body cannot fully recover, making fatigue worse.

4. Pain

Chronic pain activates the nervous system and increases muscle tension, which uses energy and contributes to exhaustion.

5. Medication Effects

Some IBD treatments, including steroids, may disrupt sleep or mood, which can intensify fatigue.

6. Nutrient Malabsorption

Inflamed intestines may not absorb nutrients effectively. Low levels of iron, magnesium, B vitamins, or electrolytes can significantly reduce your energy levels.

7. Stress, Anxiety, or Depression

Managing a chronic condition is emotionally taxing. Stress affects sleep, appetite, and energy, and can make fatigue feel more severe.

Simple Ways to Manage IBD Fatigue

Pace Yourself to Conserve Energy

Plan tasks in smaller segments, take breaks before you feel drained, and avoid overexerting yourself on “good days.” Consistent pacing helps preserve energy.

Support Better Sleep

Good sleep habits include:

• Going to bed and waking up at consistent times
• Reducing screen use before bed
• Creating a calming nighttime routine
• Avoiding heavy meals late at night

If sleep issues persist, talk to your provider; treating inflammation often improves sleep.

Gentle Movement Helps

Light physical activity improves circulation, mood, and stamina. Walking, stretching, yoga, or low-impact exercises can boost energy. Start slowly and adjust based on symptoms.

Stay Hydrated and Nourished

Balanced nutrition supports overall energy. If appetite or absorption is an issue, ask your provider about supplements such as iron, B12, folate, vitamin D, or electrolytes.

Manage Stress in Small Ways

Simple practices such as deep breathing, meditation, journaling, or talking with a counselor can reduce emotional load and alleviate fatigue.

Track Your Fatigue

Noting when fatigue improves or worsens can help identify triggers and guide treatment adjustments.

How Biologic Therapy May Help Improve Fatigue

Because inflammation is a major driver of IBD fatigue, anti-inflammatory treatments can improve energy levels. Biologic therapy targets specific immune pathways, helping control inflammation more precisely than some traditional treatments.

Many people receiving biologic therapy experience:

• Fewer flares
• More stable symptoms
• Better sleep
• Reduced pain
• Patients find that fatigue lessens or becomes more manageable once inflammation is under control.

When to Talk with Your Healthcare Provider

Contact your provider if:

• Fatigue suddenly worsens or lasts longer than usual
• You feel exhausted even when your IBD appears controlled
• You experience dizziness, pale skin, or rapid heartbeat (possible anemia)
• Fatigue interferes with work, school, or daily activities
• You have nighttime symptoms affecting sleep
• You notice weight loss, bleeding, or fever

Fatigue is a legitimate symptom, not something you must “push through.” Your care team can identify the causes and determine whether treatment adjustments, including biologic therapy, may be beneficial.

FAQ: Understanding and Managing IBD Fatigue

1. Why does IBD make me feel so tired?

Inflammation, anemia, sleep disturbances, pain, and nutrient changes work together to drain energy, creating profound fatigue.

2. Is IBD fatigue the same as regular tiredness?

No. IBD fatigue is more intense and longer-lasting, and is not relieved by rest, because it is driven by medical factors such as inflammation.

3. What helps with fatigue from Crohn’s disease or ulcerative colitis?

Pacing activities, improving sleep habits, staying hydrated, gentle movement, managing stress, and correcting nutrient deficiencies can help. Biologic therapy may also reduce fatigue by controlling inflammation.

4. Can biologic therapy improve fatigue?

Yes. By reducing inflammation and stabilizing symptoms, biologic therapy may gradually lessen fatigue.

5. When should I talk to my doctor about worsening fatigue?

If fatigue suddenly increases, affects daily life, or is accompanied by dizziness, bleeding, fever, or weight loss, contact your provider.