Irritable bowel syndrome, or IBS, is a very common chronic condition, disrupting the lives of an estimated 25 to 45 million Americans. It’s most well known as a gastrointestinal condition that manifests itself in flare-ups of upset stomachs, cramping, bloating, and other gut issues that cause intense discomfort and pain.
But many people who struggle with IBS also report another symptom that’s less well-known but still widely prevalent: fatigue. Here’s what you need to know.
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Why does IBS cause fatigue?
The short answer: scientists are still investigating how IBS can cause fatigue, but research shows that fatigue plagues about half of the people who have been diagnosed with IBS, according to one study.
One scientific review offered a couple of potential reasons that people with IBS could also struggle with constant fatigue:
- Gastrointestinal symptoms - The most notable symptom of IBS is gastrointestinal distress, and the review reported several instances of abdominal pain, diarrhea, constipation, and bloating as being associated with fatigue. Four of these studies reported that the severity of abdominal pain was especially associated with fatigue; in other words, the worse the GI pain, the more likely it is that fatigue is going to strike.
- Psychological distress - Depression and anxiety are also common in IBS patients, which can contribute to tiredness and fatigue. There also seems to be a connection between fatigue and stress, a common trigger of IBS flare-ups. .
- Poor sleep quality - The discomfort of bloating, cramps, and other GI issues from IBS can interrupt your sleep. Unsurprisingly, IBS patients who had trouble getting enough quality sleep reported having high fatigue levels.
- Inflammation - Inflammation, your immune system’s response to potential threats and diseases, can also play a role in both fatigue and IBS.
Another hypothesis is that poor diet quality could be contributing to exhaustion and lack of energy. People who suffer from IBS often have certain “trigger” foods that they cut out of their diet to avoid gastrointestinal distress, but this can lead to nutrient depletion and subsequent tiredness and other issues. Testing for nutrient deficiencies can tell you a lot, if you suspect this could be your issue.
Finally, there also seems to be a link between IBS and chronic fatigue syndrome, a condition that leaves patients feeling extremely fatigued for months without any other underlying conditions to explain it away. Scientists aren’t sure of the exact cause behind chronic fatigue syndrome, and it may in fact be a result of a combination of factors like psychological stress and viral infections. Interestingly enough, one of those potential factors could be IBS. In fact, it’s been found that people who have chronic fatigue syndrome are more likely to report a previous IBS diagnosis. Some hypotheses to explain these links cite the disruption of intestinal microbiota (the bacteria in your gut), dysfunction of the gut barrier, and intestinal immunity as potential contributors to chronic fatigue syndrome.
Other potential causes of fatigue
But of course, IBS isn’t the only cause of fatigue. It happens from a number of other causes, ranging from lifestyle choices to hormones and even other serious and underlying health issues.
Lifestyle factors like alcohol use, certain medications, and lack of physical activity can all leave you feeling tired and drained. Your nutrition matters a lot as well, so eating a poor overall diet could also be hurting your alertness. For example, deficiencies of the nutrients Vitamin B12 and iron have both been linked to anemia, a condition in which your red blood cells aren’t able to carry enough oxygen to your cells. This can manifest itself as fatigue and weakness.
Fatigue could also be a clue that you’re dealing with a hormonal imbalance. Hormones are your body’s chemical messengers. They’re involved in a ton of actions in cells and systems throughout your entire body, so they can leave you feeling especially “off” when levels are too low or too high. Take your thyroid hormones: they’re key drivers for your metabolism and energy, so feeling unexplainably tired all the time can sometimes be a clue that you’re dealing with low thyroid levels. Cortisol, your “stress hormone” produced by your adrenal gland, could also be playing into your tiredness — some people theorize that when you’re constantly stressed out and pumping out cortisol, your adrenal glands eventually can’t keep up with the demand, ultimately leading to adrenal fatigue.
Keeping your hormones in mind when dealing with fatigue is especially interesting in this case since there’s evidence that IBS and certain hormones like estrogen and progesterone are related! Estrogen and progesterone are thought to trigger IBS flare-ups, and IBS-related fatigue is also more common in females (about 2 in 3 cases, to be exact).
Constant fatigue could also be a symptom of other serious underlying health issues, which is why it’s so important to check in with a health professional if you’re always dealing with tiredness that can’t be easily explained.
Can supplements help you overcome IBS fatigue?
There aren’t many studies out there that address the use of supplements for IBS and concurrent fatigue all at once, but there is plenty of research out there about supplements and fatigue or IBS in general. Here’s what we know:
- Probiotics, or live “good” bacteria, are a popular supplement among people with IBS since it can help reintroduce beneficial microorganisms to your gut to aide with digestion and metabolism. While this study found that there was “excellent” evidence for the use of probiotics in IBS, there was insufficient evidence to support its use as a treatment for chronic fatigue syndrome.
- Fiber supplements are another interesting topic when it comes to IBS. Fiber is a type of carbohydrate that your body can’t digest on its own. As such, many people who have IBS report that eating fiber is a trigger for uncomfortable symptoms like bloating and gas. But on the other hand, it’s also sometimes recommended as a treatment for IBS! In particular, soluble fiber like psyllium (which is found in many fiber supplements) seems to be more tolerable for IBS patients and has been linked to the improvement of IBS symptoms like constipation. But the symptoms evaluated here don’t include fatigue, so whether or not fiber can help IBS-related fatigue is still up in the air.
- Vitamin B12 is often recommended as a potential supplement for people who suffer from fatigue, since a B12 deficiency can impact your red blood cells and lead to tiredness and fatigue. However, one study found that a supplementing a surplus amount of B12 in IBS patients did not result in any significant changes in fatigue.
- Peppermint oil is another supplement that’s been thrown around often as a solution for IBS pain. It’s a more alternative option, but there is solid evidence that peppermint oil can actually help alleviate pain from IBS. The studies on peppermint oil and fatigue, on the other hand, are more limited, but one study found that cardiac patients who inhaled peppermint oil showed decreased fatigue levels, and other small studies on rats have seen peppermint oil be effective for reducing exercise-induced fatigue.
Tips for improving fatigue from IBS
Fatigue is a multifaceted issue, especially when you are also dealing with IBS at the same time. But the good news is that there is definitely hope for people who suffer from IBS-related fatigue. Take this case study, for example, someone with IBS who reported issues with sleep and disturbance was treated with a combination of elimination dieting, botanical and dietary supplements, and lifestyle modifications and ultimately saw a decrease in symptoms and subsequent improvements in their quality of life!
- Elimination diets: Figuring out food triggers is a good idea for managing all IBS symptoms, fatigue included, which is why elimination diets are a popular method for managing IBS. Some people who have IBS find that they can better control their symptoms by following a low-FODMAP diet that eliminates certain kinds of sugars that have been linked to IBS flare-ups. Please note, though, that you’ll want to do this under the supervision of a health professional since following a low-FODMAP diet can be highly restrictive.
- Make sure you’re fully nourished: While the jury is still out on whether or not dietary supplements on their own are an effective way to ease IBS-related fatigue, there’s no question that deficiencies of certain nutrients can lead to fatigue and tiredness over time. You can monitor your diet, but the best way to ensure you’re getting all the nutrition your body needs is by taking a blood test, either through Base’s at-home Energy Test or from your doctor. It’ll help you narrow down where your fatigue might be stemming from — and when it comes to such a broad and generalized symptom, this can be invaluable!
- Lifestyle changes: General good habits might also positively impact your energy levels. Exercising regularly, choosing complex carbs over simple sugars more often for better blood sugar control, and staying well-hydrated are good ideas for your stomach and your energy.
While scientists still aren’t completely sure about the relationship between IBS and fatigue, it’s undeniable that many people who suffer from IBS also report having to deal with instances of fatigue and tiredness. Getting to the bottom of your fatigue means understanding your IBS on a deeper level; by getting regular blood tests and consulting with health professionals like doctors and nutritionists, you’ll be better able to gain control over your gastrointestinal system.
Struggling with fatigue?
Take our quiz to build a bespoke testing plan that will help you understand the causes of your fatigue so you can beat it!
