Fatigue & IBD: 5 Common Reasons You’re Exhausted (and What Can Help)
Energy levels naturally rise and dip for most of us depending on many different factors. But if you live with IBD, that tiredness can hit on a completely different level.
Fatigue is one of the most common and frustrating symptoms in Crohn’s and Colitis, and yet it is often overlooked or brushed off as something you just have to live with. That is not the case.
In this post, I am breaking down the five biggest reasons fatigue is so common in IBD, plus some simple, practical ways to start supporting your energy.
Fatigue in IBD is incredibly common
Research consistently shows that fatigue affects a large proportion of people living with IBD.
A large review found that:
Around 80 percent of people experience significant fatigue during active disease
Around 50 percent still experience fatigue even in remission
So if you are sitting there thinking, “I shouldn’t feel this tired when things are technically under control”, this is your reminder that it is not in your head. There is a reason for it, and it is very well recognised in the research.
Fatigue in IBD is complex, and it is rarely down to just one thing. It is usually a combination of factors working together.
1. Inflammation
Inflammation is one of the biggest drivers of fatigue in IBD.
When your immune system is active, your body is constantly working in the background. It is repairing tissue, managing immune activity, and trying to bring things back into balance. All of this requires a lot of energy.
You might not always feel “unwell” in the traditional sense, but internally your body is working hard.
What can help:
Ensuring you have receive proper medical support to reduce inflammation levels in the gut.
Reducing overall inflammatory load through nutrition and lifestyle.
Ensuring your body has enough fuel going in to cope with demand.
2. Not eating enough (often unintentionally)
This is something I see a lot.
When symptoms are flaring or unpredictable, eating often becomes harder. You might naturally reduce portion sizes, avoid foods, or simply lose appetite due to discomfort or stress around food.
The problem is that when inflammation is higher, your body actually needs more energy, not less.
This mismatch can quickly contribute to fatigue.
What can help:
Regular, consistent meals (even if they are smaller)
Easy-to-digest, low-stress meals during symptom flare-ups
Soft, simple textures if needed (soups, stews, smoothies, mashed meals)
Having a “baseline” of safe foods you can rely on
3. Dehydration
Hydration is often underestimated, but it plays a big role in energy levels.
If you are experiencing looser stools or more frequent bowel movements, fluid and electrolyte losses can be significant. Even mild dehydration can contribute to tiredness, headaches, and reduced concentration.
What can help:
Regular fluid intake throughout the day (not just large amounts at once)
Adding electrolytes, especially during flares
Including hydrating foods such as soups, fruit, and smoothies
4. Nutrient deficiencies
People with IBD are at higher risk of certain nutrient deficiencies, which can directly contribute to fatigue.
Some of the most common include:
Iron
Vitamin B12
Folate
Vitamin D
Zinc
Inflammation can also affect how well some of these nutrients are absorbed and utilised. For example, iron metabolism can be disrupted during inflammatory states, meaning levels may look “okay” on basic tests while stores are actually low.
This is why more detailed testing and interpretation is often needed.
What can help:
Full iron studies (including ferritin, not just haemoglobin)
Regular monitoring of B12, folate, and vitamin D
Targeted supplementation based on results, not guesswork
Working with someone who understands how to interpret IBD-specific blood results
Optimising digestive function and prioritising easy-to-digest and absorb foods
5. Sleep and stress
Fatigue is not just physical. It is also deeply connected to sleep quality and stress levels.
Things like night-time bowel movements, abdominal discomfort, anxiety around symptoms, or simply the mental load of living with a chronic condition can all impact sleep and recovery.
And when sleep is disrupted, energy levels the next day are inevitably affected.
Stress also plays a role here. When your body is under-fuelled or inflamed, your stress resilience naturally drops, which can make everything feel harder.
What can help:
Supporting gut symptoms that disturb sleep (especially in the evening)
Creating a simple and calming wind-down routine
Ensuring you are eating enough to support stress regulation
Addressing both physical and emotional load, not just one or the other
The important takeaway
Fatigue in IBD is rarely caused by one single thing. It is usually a combination of inflammation, nutrition, hydration, nutrient status, sleep, and stress all layering together.
The encouraging part is that these are also the areas where support can make a real difference. When we start to address the foundations properly, energy often improves more than people expect.
You do not have to accept feeling like this
If fatigue is one of your biggest struggles right now, you are not alone in it. And more importantly, there are ways to support your body so you can feel more energised and more like yourself again.
If this resonates, you can book a free consultation call to talk things through and explore how personalised nutrition and lifestyle support can help.