Fighting fatigue can be a constant battle when you have inflammatory bowel disease. You might be struggling to remember things or perhaps look and feel like you’re a zombie. In our previous article we talked about Crohn’s Disease and Ulcerative Colitis - two conditions under the umbrella of Inflammatory Bowel Disease (IBD) and that it can cause iron deficiency anaemia. While fatigue can have several causes, we go in depth on how iron deficiency anaemia develops and give you SEVEN tips on what you can do to fight it.
Firstly, What is iron deficiency anaemia?
Iron deficiency anaemia happens because the body does not have enough iron stores to create healthy red blood cells. These cells are responsible for carrying oxygen to feed your organs, muscles and tissue. That’s why iron deficiency anaemia can leave people feeling tired, short of breath, having headaches, looking pale and having cold hands and feet.
There are two forces going against you in IBD: too little iron coming in, and too much iron going out.
How does iron deficiency develop in these conditions?
Let's dive into how iron deficiency occurs in IBD.
Too little iron coming in:
Firstly, you might not feel like eating or feel nauseous. Resulting in less food intake and lower amounts of iron, amongst other nutrients, to be available to the body.
Secondly, inflammation can reduce the amount of iron absorbed into the body. Think about how hard it would be to insert a coin into a piggy bank if the slot is swollen. Inflammation in the bowel makes it harder for the nutrients to enter the blood stream.
Too much iron going out:
Over time, chronic inflammation causes ulcers or sores in the intestines. During a flare, the attack is relentless; there is no time for the sores to heal, so they continue to bleed. Since your blood contains about 60% of the body’s iron, that accounts for a lot!
What can be done to manage iron deficiency anaemia in IBD?
First and foremost, don’t accept tiredness as a “new-normal”. Talk to your doctor if you are worried you have iron deficiency anaemia and haven’t had a recent blood test.
Seven things you can do include:
- Work hard to control the source of the problem: inflammation. While there is no cure, IBD can be managed. Be open and honest with your doctor, especially if your symptoms don’t seem to improve or if side effects are getting on top of you. Together, you can find the right option that works for you.
- Keep an eye on blood tests. If your iron is low, ask the doctor about how to manage it. Options include oral tablets or infusions (which can be given at the hospital, private clinic or some GP practices). Schedule regular check-ups and blood tests to track iron levels and treatment progress. This could be as frequent as every 3, 6 or 12 months depending on the stage of your IBD.
- Manage the symptom multipliers. Stress, smoking, caffeine and alcohol can make your symptoms worse.
- Fill up on nutritious fuel: There is no particular diet that you should follow. The key thing is to replenish your body by eating a well-balanced diet. If you haven’t already, ask your doctor for a referral to a specialist dietician for personalised advice.
- Don’t sweat the small stuff. Energy is a precious commodity. Set realistic goals on what you can achieve in the day, and importantly listen to your body.
- Get moving. When you can manage, fit in some exercise, even if its low intensity walking or some resistance exercises. While exercise doesn’t have much impact on inflammation, it can help improve overall wellbeing.
- Get support. Don’t be afraid to tell family and friends about how you feel during a flare, and importantly about how they can help you. You can also approach support groups for help. There’s nothing like the feeling of chatting to people who really understand what you’re going through. You can find several support groups linked under External Resources below.
Be open and honest with your doctor, especially if your symptoms don’t seem to improve or if side effects are getting on top of you.
Together, you can find the right option that works for you.
- 1. Lamb CA, Kennedy NA, Raine T, et al. British Society of Gastroenterology consensus guidelines on the management of inflammatory bowel disease in adults Gut 2019;68:s1–s106
- 2. Chiefetz A, Gianotti R, Luber R, et al. Complementary and Alternative Medicines Used by Patients With Inflammatory Bowel Diseases. Gastroenterology 2017;152:415-429
- 3. Lopez A, Cacoub P, Macdougall I, et al. Iron deficiency anaemia. Lancet 2016;387:907-16