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Best Ways to Manage It

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Best Ways to Manage It

Living with a chronic disease often means monitoring and tracking your symptoms, such as fatigue. This allows you to identify triggers, such as food and stress. It can also help you detect relapses early when the disease is inactive or in remission.

When Crohn’s disease fatigue is getting in the way of your daily life, here are some of the ways you can manage it:

  • Rule out underlying anemia
  • Take the necessary supplements as directed by your healthcare provider
  • Treat flare-ups
  • Switch medications
  • Manage sleep
  • Manage stress
  • Eat well
  • Exercise regularly
  • Budget your energy

1. Assess Anemia

About 1 in 3 people with Crohn’s have anemia.

A blood test can determine whether or not you’re anemic. At its most severe, anemia is life-threatening. Iron supplements given orally or through an IV (intravenously) can also help with iron deficiency. According to the American Society of Hematology, blood transfusions can be a temporary solution if there is severe anemia.

While blood transfusions improve your blood levels, you will need to take other steps to address or prevent anemia.

2. Take a Supplement

You might need more than iron supplements to make up for any nutritional deficiencies in your diet. Studies have also reported a higher risk of folic acid deficiency in patients with IBD.

Crohn’s patients may also have low vitamins B12 and D, Rao adds. Dr. Choudhary says she often recommends that Crohn’s patients take a multivitamin and have frequent blood tests to check for nutrient deficiencies. Consider talking with a dietitian who specializes in Crohn’s disease or your doctor before taking any new supplements.

3. Treat Flare-Ups

When symptoms reappear or worsen, you may be in a flare-up. Stress, smoking, and taking certain medications can all contribute to Crohn’s flare-ups.

 This is when symptom monitoring becomes especially handy — it allows you to identify potential causes of flares, which you can relay to your doctor.

Make sure you’re following all of the necessary steps to avoid and treat your Crohn’s flares. This means taking prescribed medication according to your doctor’s instructions in addition to maintaining a healthy lifestyle.

4. Switch Medications

Certain medications can contribute to Crohn’s flares. Nonsteroidal anti-inflammatory medicines (NSAIDs), for example, may exacerbate inflammation of the bowel and worsen Crohn’s symptoms. If fatigue is a side effect of one of your medications, you might need to switch. Do so only with your doctor’s supervision.

5. Manage Sleep

Talk with your doctor about ways to improve life with Crohn’s so you can get some shut-eye, especially if symptoms are keeping you up at night.

Also review your entire sleep hygiene routine to make sure you’re giving yourself a chance to get enough good-quality sleep. The Crohn’s & Colitis Foundation recommends going to sleep and waking up at the same time everyday and using fewer electronics closer to bedtime.

You should also create a bedtime routine that’s conducive to quality sleep, such as creating a calming environment in your bedroom, Rao adds.

6. Manage Stress

Yes, Crohn’s is stressful. Stress in itself is tiring and can interfere with sleep.

You’ll want to identify your stressors as part of an overall strategy to reduce stress, says Rao. The Crohn’s & Colitis Foundation advises patients to take up cognitive behavioral therapy (CBT), mindfulness, and meditation to relieve emotional stress if it’s impacting your life — your gastroenterologist can refer you if this is needed. Taking a warm bath before bed or having a cup of chamomile tea can help set a relaxing mood.

It may take time to settle into a stress management routine — living with Crohn’s for over 30 years has helped Domilici gain some perspective and discover strategies to cope with the emotional and psychological challenges. Some examples include managing iron and vitamin deficiencies, reducing psychological and emotional stress, and improving your sleep routine.

7. Eat Well

There isn’t a one-size-fits-all diet for Crohn’s disease, but food can still play a role in symptom and disease management.

For starters, people with Crohn’s disease may have food triggers that worsen their symptoms or contribute to flares. High-fiber foods, coffee, alcohol, sweeteners, dairy, and spicy foods are all examples of potential food triggers.

Keeping a food or symptom log can help you identify which foods and drinks are more likely to trigger Crohn’s symptoms so you can limit or avoid them. You should also aim to follow a balanced, nutrient-dense diet that includes fruits, vegetables, healthy fats, whole grains, and leafy greens. Working with a nutritionist is key to understanding how diet can impact your gastrointestinal health.

8. Exercise

“It’s important for Crohn’s patients to find a form of exercise that they enjoy and can sustain,” Rao says. “Regular physical activity can help reduce stress, anxiety, depression and improve overall well being especially in patients who have chronic medical conditions.” The general recommendation is to aim for at least 150 minutes of moderate aerobic exercise per week.

But check with your doctor before starting a fitness plan, Choudhary advises. If you have severe anemia, working out may make you feel even more fatigued. “If you are over 65, have low hemoglobin, exercise can put a strain on the heart,” she says. Also, if you’re experiencing flare-ups, it’s better to let the body rest before exercising.

9. Budget Your Energy

When you have limited energy, you’ll need to use it wisely. Consider the concept of treating your energy levels like money and budgeting it appropriately.

“It’s a matter of being good at prioritizing and delegating,” Domilici says. “Look at your week and have a sense of what you can manage and not manage.” If your day is overbooked, cut some of your commitments.

Crohn’s patients may even need to take time off from school or work obligations or obtain necessary accommodations from their physician as needed, Dr. Dibba says.

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