Fatigue in inflammatory bowel disease

Fatigue in inflammatory bowel disease

What is fatigue?

Fatigue is a very common symptom of inflammatory bowel disease (IBD) and is often described as one of the most difficult symptoms to live with, after pain and diarrhoea, by people with Crohn’s disease and ulcerative colitis.1

Fatigue is an extreme form of tiredness that doesn’t go away with the usual amount of rest or sleep.2 It can affect each person differently, but typically fatigue can feel like never-ending tiredness.

Fatigue can impact your physical and emotional wellbeing and quality of life,3 and is the most common reason for people living with inflammatory bowel disease to be absent from work.4 Even people in remission report feeling fatigued.4

However, there are some things you can do to manage your fatigue and reduce its severity. Learn more below.

Why am I experiencing fatigue?

An IBD patient experiencing fatigue, a symptom of IBD.

There are several contributing factors associated with fatigue in Crohn’s disease and ulcerative colitis, but major contributors include some or all of:5,6

  • Increased disease activity (a flare-up), which can prevent you from absorbing enough nutrients, vitamins and minerals from your diet
  • Poor sleep
  • Some medicines used to treat IBD can cause fatigue
  • You may have lost some overall strength and fitness after periods of being very inactive
  • Anxiety and depression
  • Stress

Fatigue may also be a symptom of other diseases that people with IBD are more likely to develop, such as other autoimmune disorders.6

How can I manage my fatigue and minimise its impact on my life?

Try not to just dismiss the exhaustion you are feeling: you are not lazy for struggling with fatigue. Because fatigue can be caused by any number of things, there are many practical options that you and your healthcare team can explore to help you take control of it.2

Talking to others about your fatigue

Fatigue can be hard to explain to other people, even those who are very willing to listen. To most people, feeling very tired is associated with a long week at work or being out socialising, which is a world apart from what you are experiencing. You can find some support on communicating about your condition and answering questions from your loved ones in Talking about your IBD.

Just finding the words to communicate how you are feeling can be very difficult but talking to your healthcare team about your fatigue is very important.

You can use the Fatigue scale below to pin-point how you are feeling and use this as a support when talking with your doctor.7

An infographic showing a fatigue scale, with zero meaning no fatigue experienced and 10 meaning extreme fatigue

Managing other symptoms

Look after your diet and hydration: Although there is no single diet plan proven to help fatigue, a varied and balanced diet can help. Learn more about the importance of nutrition in IBD.

Dehydration is another common culprit, especially during a flare-up. Learn more about how to manage dehydration.

Look after your physical health: Activities that promote increased muscle mass and bone health can be beneficial for people living with IBD.6 Learn more about the benefits of exercise.

Look after your mental health: Some people find cognitive behavioural therapy (CBT) and stress management helps them with their fatigue, and this may be offered to you by your doctor.

10 top tips for managing fatigue


Hear from Crohn’s & Colitis UK and watch a rundown of the top tips for managing fatigue and making it more manageable to deal with.

*IBDrelief patient survey data from 167 respondents with IBD in the UK. 74% of respondents reported daily fatigue. 56% of respondents reported a severity of fatigue score of 8 or more on an 11-point scale, where 0 = not severe and 10 = very severe.3


CBT = cognitive behavioural therapy, CD = Crohn’s disease, IBD = inflammatory bowel disease, UC = ulcerative colitis.

  1. Fan VSK, et al. Systematic review: patient-reported outcome measures of fatigue in inflammatory bowel disease. Fatigue: Biomed Health Behav. 2022;10(2):60–82.
  2. IBDrelief. Impact of IBD on physical and emotional health: Findings from an IBDrelief survey. Available at www.ibdrelief.com/impact-of-ibd-on-physical-and-emotional-health. Accessed October 2023.
  3. van Langenberg DR, Gibson PR. Systematic review: fatigue in inflammatory bowel disease. Aliment Pharmacol Ther 2010;32(2):131–43.
  4. Davis SP, et al. Influencing Factors of Inflammatory Bowel Disease-Fatigue: A Path Analysis Model. Nurs Res. 2021;70(4):256–65.
  5. Kreijne JE, et al. Practical guideline for fatigue management in inflammatory bowel disease. J Crohns Colitis 2016;10(1):105–11.