Fatigue and Digestive Disorders

Fatigue and Digestive Disorders


Fatigue is a lack of energy or feeling of debilitating tiredness. It is a symptom commonly experienced by many patients, including those with digestive system disorders. The digestive system is responsible for processing nutrients in the body. Any malfunction of the digestive system can either interrupt how the body receives nutrients or cause problems such as bleeding, which may also produce fatigue.

All types of digestive disorders may cause fatigue. Liver diseases, such as hemochromatosis, viral hepatitis, cirrhosis and fatty liver may produce fatigue as the liver fails to process nutrients and toxins adequately. Diseases that may cause gastrointestinal bleeding, such as peptic ulcers, may produce fatigue because the body slowly loses blood. Other disorders may involve the malabsorption of nutrients during digestion, which may result in fatigue. Fatigue can be a symptom of the disease itself or a side effect caused by treatment. Lack of sleep, stress and depression related to digestive conditions can also lead to fatigue.

Fatigue can seriously impede normal functioning and interfere with a patient’s ability to maintain healthy relationships or derive pleasure from favorite activities. It is characterized by more than just a feeling of tiredness. It is defined as a complete lack of energy or feeling of debilitating tiredness. Feelings of fatigue vary for every individual and may be more severe in some patients than others.  Fatigue may also be accompanied by other symptoms, such as headaches and irritability.

Fatigue can be acute or chronic in duration. Individuals who experience severe, persistent and often debilitating fatigue for six months or longer may suffer from a condition called chronic fatigue syndrome (CFS) or another underlying medical condition.  If fatigue exceeds two weeks and has no obvious cause, individuals should seek medical care.

There are no specific medical tests for measuring fatigue. However, the physician will typically perform a physical examination, including various tests to identify any underlying medical causes of fatigue.

When fatigue is the result of a digestive system condition, treatments are often designed to address the condition itself. For patients whose medication may be contributing to their fatigue, alternative drugs may be prescribed. Additional options for treating or preventing fatigue can include exercise, possible diet changes and adhering to an activity and rest schedule.

About fatigue

Fatigue is defined as a complete lack of energy or feeling of debilitating tiredness. It is a symptom often associated with many digestive system conditions. The process of digestion delivers nutrients that provide energy to all body tissues. Any condition that affects that process may produce numerous symptoms including fatigue.

Fatigue may also be a normal physical response to factors such as:

  • Lack of sleep. People who get even an hour less sleep than their body requires are likely to feel drowsy. The older people get, the less soundly they sleep. Sleep requirements vary by age. Most adults need about eight hours of sleep, whereas children’s sleep requirements range from 16 to 20 hours for newborns to around 9.5 hours for adolescents.

  • Physical exertion or inactivity. It is normal to feel fatigued after strenuous activity. However, the longer-term effect of physical exertion is actually an increase in energy level. By contrast, people who are inactive may become easily fatigued by even moderate exertion.

  • Stress or anxiety. People who feel anxious or on edge may not be able to relax or to get proper rest, resulting in fatigue.

  • Boredom or depression. These emotions can sap a person’s energy, creating feelings of lethargy and fatigue.

  • Lack of proper diet. People who eat too little or do not consume enough fluids are likely to have less energy and to feel more fatigued. Patients should consult their physician about the proper intake of food and fluids for their age and size.

  • Vitamin deficiency. Inadequate amounts of certain vitamins (e.g., vitamin B1, folic acid, vitamin B12) can cause feelings of fatigue. Patients who do not consume a sufficient amount of these vitamins in their diet may benefit from taking a daily multivitamin.

Fatigue associated with these factors may be acute or chronic in duration. The fatigue often disappears after the patient becomes rested. Even though fatigue can greatly affect patients’ lives, many individuals do not report it to healthcare professionals. Patients experiencing fatigue that lasts for at least two weeks and has no obvious cause are encouraged to notify their physician. This may indicate the presence of a condition called chronic fatigue syndrome (characterized by severe, persistent and often debilitating fatigue for six months or longer) or another underlying medical condition.

There are no specific medical tests for measuring fatigue. However, the physician will typically perform a physical examination, including various tests to identify any underlying medical causes of fatigue.

Other symptoms related to fatigue

Patients usually characterize fatigue as a feeling of lacking energy or feeling weak, tired, worn out, exhausted, weary or slow. Fatigue may be associated with an increased need for rest or the inability to regain energy after rest periods.

 Psychological symptoms associated with fatigue may include:

  • Lack of motivation
  • Lethargy
  • Sadness
  • Irritability
  • Frustration
  • Apathy

There are also physical responses to fatigue, which may include:

  • Inability to sleep
  • Oversleeping
  • Drowsiness
  • Feeling of heaviness in the arms and legs
  • Muscle pain
  • Headaches

Potential causes of fatigue

Causes of fatigue can be behavioral, psychological or biological in nature. Therefore, the origin of fatigue can be difficult to medically diagnose.

Many liver diseases, including viral hepatitis, cirrhosis, hemochromatosis and fatty liver affect the liver’s ability to process nutrients and toxins. This may produce fatigue. Other interruptions in the digestive process, such as bleeding from peptic ulcers or the malabsorption of nutrients may also affect functioning and eventually produce fatigue.

Debilitating conditions such as inflammatory bowel disease and ulcerative colitis also produce fatigue. Fatigue can also result from anemia related to gastrointestinal stromal tumors. These rare and often cancerous growths can occur anywhere in the digestive tract, particularly the stomach.

In some cases, fatigue can result from medications used to treat diseases. For example, fatigue is a side effect of a drug commonly used to treat hepatitis C. Other drugs, such as beta blocker heart drugs and antihistamines (common cold medications), can also cause fatigue.

Behavioral causes of fatigue may include:

  • Lack of sleep
  • Inactivity
  • Overexertion
  • Poor eating habits
  • Dehydration
  • Excessive consumption of alcohol or caffeine
  • Use of illegal drugs

Fatigue caused by these factors may subside naturally or with a few simple lifestyle changes, such as engaging in regular exercise or going to bed an hour earlier. Individuals may choose to keep a diary to help identify the time of day in which fatigue is most prevalent so they can adjust their schedule accordingly.

Psychological factors that can produce fatigue may include:

  • Stress
  • Anxiety
  • Depression
  • Grief

Though psychologically induced fatigue may also subside on its own, patients may benefit from mental-health counseling.

Treatment and prevention of fatigue

Fatigue by itself is a symptom rather than a diagnosable condition. Patients may seek medical help for their feeling of fatigue without even realizing that gastrointestinal (GI) disorders are the source of their symptoms.

Once a GI disorder has been diagnosed by a physician, it can be treated, which should help relieve the feeling of fatigue. If a certain medication is found to be causing fatigue, a different drug may be prescribed in its place.

Other treatment and prevention methods for fatigue may include:

  • Exercise. Many patients can help combat fatigue with regular exercise, which can improve mood, increase energy, stimulate appetite and boost endurance, strength and stamina.

    Patients should begin with short periods of low-intensity exercise, such as leisurely walking, and gradually increase the duration and intensity level of exercise over time (when appropriate). Many experts recommend at least 30 minutes of moderate activity on most days of the week. Some individuals with digestive system disorders may find it difficult to exercise. All patients should speak with their healthcare professional before beginning a new exercise regimen to determine whether exercise is appropriate for them and which exercises are most beneficial for their condition.

  • Activity and rest. Patients who experience fatigue should set priorities for their daily activities and use a schedule to conserve their energy.  A physician can help devise an activity and rest program that allows the patient to conserve the maximum amount of energy. Patients may reduce fatigue and improve their sleeping habits by lying down only when ready to sleep, limiting daytime naps, increasing their activity level during the day, eliminating sources of distracting sounds when sleeping and avoiding foods before bedtime that may interfere with sleep.

    Patients should set realistic activity goals and avoid overexerting themselves by using equipment aids (e.g., a ramp instead of stairs or an electric cart at the supermarket). These aids can help patients reduce their energy expenditure. Patients may also benefit from enlisting the help of others when errands and housework become too difficult. In addition, patients who work may choose to speak with their employer about modified responsibilities and flexible scheduling if necessary. Many patients also benefit from maintaining an activity diary, which allows them to identify activities that are particularly taxing.

  • Hydration and nutrition. Patients are typically advised to drink a minimum of eight glasses of liquids every day to remain sufficiently hydrated. They should not skip meals and are urged to eat a balanced and nutritious diet with sufficient calories, complex carbohydrates (vegetables and grains), proteins, fats and vitamins to provide sustained energy sources and help the body meet its escalating energy demands. It is best to avoid sugary cereals and juices and beverages that are caffeinated. Patients may choose to speak with a dietician regarding ways to maximize their nutritional intake. Patients may also benefit from taking a daily multivitamin.

  • Stress. Patients experiencing fatigue may benefit from reducing their stress. This can be achieved by learning relaxation techniques, such as meditation and yoga. In addition, patients should try to avoid stress when possible. This may involve changing jobs or taking a vacation.

People experiencing fatigue should avoid stimulants. Caffeine and other stimulants are not effective in the treatment of fatigue because they may worsen the disorder in the long run by interfering with sleep. Alcohol, nicotine and illegal drugs should also be avoided. In addition, sedatives should not be taken by patients suffering from fatigue. These medications can also worsen the condition.  

Patients are encouraged to monitor the level of their fatigue and contact their physician if its severity increases.

Questions for your doctor regarding fatigue

Preparing questions in advance can help patients to have more meaningful discussions with their physicians regarding their conditions. Patients may wish to ask their doctor the following fatigue-related questions:

  1. Why do I always feel tired?
  2. Are my medications making my fatigue worse?
  3. What other symptoms are related to fatigue?
  4. Could my digestive condition be causing my fatigue? If so, how?
  5. How can I relieve my fatigue?
  6. How long will my fatigue last?
  7. Are there any alternative treatments that could help my fatigue?
  8. Can my diet affect my fatigue?
  9. I have liver disease and fatigue. Is it possible I have another condition that is causing fatigue?
  10. Should I try other medications, such as sleeping pills, to relieve my fatigue?
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