Does IBS cause fatigue?
The health of your gut impacts nearly every other system inside your body. This includes the way your body produces energy. So it follows that IBS can make you feel tired.
The gut-fatigue connection
Do you remember how exhausted you felt the last time you had the stomach flu?
If your symptoms were anything like mine, you probably weren’t even able to get out of bed. I couldn’t even lay in bed and enjoy Netflix. Watching Netflix takes almost no energy. I was so sick and tired that I couldn’t even summon the will to stare at a screen.
Sleeping was all that I could do. This is an example of the huge impact your gut has on your energy levels.
So of course if you have long term GI issues like IBS you are going to have low energy.
If you are suffering from fatigue you need to fix your gut first! That’s because the health of your gut holds the secrets to more energy. You can read more about how gut bacteria affect your energy and how a leaky gut can cause fatigue in my previous articles.
Is IBS even a real condition?
IBS (irritable bowel syndrome) is a common chronic GI (gastrointestinal) disorder that involves problems with how fast/slow contents move through your intestines and how your brain interprets sensations in the bowel. (1)
IBS can occur in any age group, though it is most common in people between the ages of 20- and 50-years-old. It is also a disease primarily reported in the first world, making it likely that there is a connection to the modern, industrialized diet, as well as the higher stress levels found in modern-day careers. (4)
In all likelihood your hunter-gatherer ancestors did not suffer from IBS. The diet of your ancestors did not include chocolate bars, microwave dinners, or takeout. While I can’t say for sure that modern convenience foods cause IBS, they certainly don’t help. And they may very well be contributing.
Just like chronic fatigue, irritable bowel is a syndrome, not a disease. That means it is a collection of symptoms. There is no specific cause of IBS. Unfortunately this means that without a cause it is difficult to manage syndromes like CFS and IBS in conventional health care.
When you don’t know the cause, finding a solution becomes challenging. Fortunately, there are some steps you can take to better manage both your IBS and your fatigue.
Why treating IBS is such a pain in the gut
If you didn’t think IBS was already confusing, the way that it’s diagnosed won’t help clear things up. At the time of this writing, IBS is diagnosed using the Rome IV criteria. In order for IBS to be diagnosed, the following symptoms need to exist:
- Recurrent abdominal pain on average at least 1 day/week in the last 3 months, associated with two or more of the following criteria:
- Related to defecation
- Associated with a change in the frequency of stool (meaning that you’re tending towards either an increase or a decrease in the number of bowel movements you experience each day).
- Associated with a change in the appearance of stool (check out the Bristol Stool Chart). If you notice a dramatic change in your stool, then this section is marked positive.
These rather vague descriptions are then broken down into subtypes based on the key symptom. The IBS sub-types are:
- Constipation is the primary symptom
- Those with this type mainly suffer from loose stools or diarrhea.
- Those with IBS-M suffer from alternating or mixed loose stools and constipation.
How do you know what type of IBS you have?
The Bristol Stool Chart, shown on the right, is a great way to determine whether your bowel movements are too loose, too firm, or, just right. (5)
Types 3 and 4 are healthy bowel movements. As you move up the scale (towards 1 and 2) your bowel movements move towards constipation (IBS-C). As you move down the scale (towards 5, 6, and 7) you move towards diarrhea (IBS-D). But remember, in order to be diagnosed with IBS, you must also be suffering from abdominal pain.
For most, their IBS can fluctuate dramatically. This can make it incredibly confusing to uncover what might actually be causing your symptoms.
Is it the food you eat?
Is it your stress levels?
Was it triggered by last year’s food poisoning?
When you combine this rather confusing list of symptoms with intense levels of fatigue, it’s no wonder you’re at a loss of what to do. And we haven’t even talking about other weird and wonderful symptoms that can occur alongside IBS.
The weird and wonderful symptoms associated with IBS
People with IBS often suffer from additional symptoms outside of their digestive tract. Doctors call these extra-intestinal symptoms. These symptoms are sometimes linked to the digestive tract. But at other times they can affect other parts of the body that seem to have nothing in common with the gut.
Those strange, seemingly unexplainable symptoms you have could actually be related to IBS!
The GI-related symptoms of IBS include:
- Abdominal pain and/or cramping
- Constipation (passing three or fewer stools in a week or passing hard, dry stools and/or straining during a bowel movement)
- Diarrhea (passing three or more stools per day, and/or urgent need to have a bowel movement)
- A feeling of incomplete emptying of the bowels
Non-GI related symptoms of IBS:
- Back pain
- Frequent urination
- Sleep irregularities (difficulty falling / staying asleep)
- Heart palpitations
If you’ve already tried to get conventional treatment for IBS, you know how frustrating this can be. It only becomes more challenging when your IBS causes fatigue, headaches, or anxiety. That’s because medical professionals often dismiss these symptoms as they don’t realize they are related.
And unfortunately that includes fatigue. Even though IBS and fatigue usually go hand in hand. (6) I’ll show you why IBS makes you tired in the next section!
Why does IBS make you tired?
Well over half of people with IBS also report suffering from fatigue. (7) In fact, fatigue is the third most common symptom for those with IBS. The only two more common symptoms? Abdominal pain and altered bowel movements. (8)
There is a direct connection between fatigue and GI symptoms. The worse the abdominal pain / GI symptoms, the worse the fatigue. Some studies found fatigue worse in IBS-C. Other studies found fatigue worse in IBS-D.
But no matter which IBS you suffer from, you are going to suffer from fatigue.
Your guts connect to your brain through a super-highway of nerves. Some call this the gut-brain axis. Below, I’ll show you how the gut-brain axis can wreak havoc on your energy levels!
How exactly does IBS cause fatigue?
To be honest, researchers are not sure. Studies have started to find some connections. But connections aren’t a cause.
Below, I describe some of the more common connections between IBS and fatigue. Please note that these are just connections, not causes.
Anxiety & depression:
Anxiety and depression often go hand in hand with IBS. (9) While we don’t know why that is, we do know that a symptom of anxiety and depression is fatigue. So, if you suffer from anxiety or depression as well as IBS, it’s very likely this is the cause of your fatigue.
Does that mean if you improve your sleep, you’ll improve your IBS?
It’s a great question. I do know that improving your sleep will have a huge, positive impact on many different areas of your life. So, it’s certainly worth your time to do everything you can to improve your sleep. I’ve written about ways you can start improving your sleep.
I often discuss the importance of adopting a low-inflammatory diet if you have IBS. That’s because people with IBS also suffer from increased inflammation throughout their body. It turns out that these people also report higher levels of fatigue. (12, 13) So it follows that if you suffer from IBS and fatigue you need to lower inflammation any way you can. In fact, food sensitivities are often linked to elevated levels of inflammation (and therefore fatigue).
In general, people with IBS suffer from a type of fatigue called central fatigue. Central fatigue starts in the brain or central nervous system and causes that general feeling of malaise or exhaustion. You may also experience it as brain fog or sluggishness.
At the time of this writing, researchers don’t know why IBS causes central fatigue. The most promising theory is the gut-brain axis. The gut-brain axis is a series of nervous that connect your gut to your brain. Through this nervous system, your body senses and experiences its GI tract and relays that information to your brain. (14)
Imagine if you saw a bear or cougar while you were hiking. You’d feel anxious/nervous, right?
If you have an infection in your gut – a hidden cause of IBS – your nervous system has a similar response. Only in this case, you don’t know why you’re feeling anxious. That’s because the hidden infection in your gut is causing the anxiety. This is the gut-brain axis in action. And it could be a promising field of research in the coming years!
So, how should IBS and fatigue be treated?
First, the root cause of your symptoms needs to be identified.
And unfortunately you won’t get an answer from your conventional medical practitioner. Instead, you will only receive treatment for your symptoms.
Conventional treatment for IBS will depend on the type of IBS you have. For IBS-C, stool softeners and laxatives are often prescribed. For IBS-D, antidiarrheals from the opioid family are prescribed. Medications used to ease muscle spasms (antispasmodics) will often be recommended for abdominal discomfort. While there is not a lot of evidence, low doses of antidepressants are also sometimes prescribed.
The key thing to remember is that conventional treatment of IBS does not look for the root cause of the disease. However, when the root cause is found and removed, you should no longer need continuous medical intervention.
A different type of treatment
At Flourish Clinic, we take the Functional Medicine approach and begin the treatment of both IBS and fatigue with changes in nutrition. This includes either lab testing or a reset diet to determine what foods you best tolerate. Sometimes, simple dietary changes are enough to completely eliminate your symptoms.
When diet therapy does not change your symptoms, the next step is looking to see if you have a hidden gut infection like SIBO or Blastocystis Hominis. Often, these hidden infections contribute to your IBS and fatigue symptoms.
Ok, now you know that there is a link between IBS and fatigue. There is a medically documented connection between IBS and fatigue.
Now, I want to hear from you!
How has the health of your gut impacted your energy levels?
What strategies have you found to improve both your IBS and fatigue?
Share your answers in the comments section below.