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Fatigue and IBD. Debbie Pullen Liaison Mental Health Nurse Liaison Psychiatry. Background. •IBD affects 3.6 million people worldwide & 240,000 in the UK •Fatigue is common in IBD •Leading concern for IBD patients- during remission 40% of people affected

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Fatigue and ibd
Fatigue and IBD

Debbie Pullen

Liaison Mental Health Nurse

Liaison Psychiatry


Background
Background

  • •IBD affects 3.6 million people worldwide & 240,000 in the UK

  • •Fatigue is common in IBD

  • •Leading concern for IBD patients- during remission 40% of people affected

  • •Multifaceted, unpleasant, distressing

  • •Subjective and poorly understood

  • •Fatigue is poorly managed


Definition of fatigue
Definition of fatigue

  • An overwhelming sense of unrelenting tiredness, lack of energy or feeling of exhaustion that is not relieved following rest or sleep


Reasons for fatigue
Reasons for fatigue

  • Pain

  • Anaemia due to malabsorption of vitamins and minerals

  • Sleep disturbances – many causes!

  • Side effects of medication eg steroids which can make people feel “wired” or other medications which cause drowsiness


Reasons for fatigue cont
Reasons for fatigue cont

  • Changes in mood eg depression

  • Stress levels

  • Disease activity eg inflammatory processes cause fatigue


Managing fatigue
Managing fatigue

  • Compare energy to a battery

  • Healthy person = charged battery

  • Need to ration energy

  • Need to learn how to increase

    energy eg relaxation

  • Relying on emergency supplies


Fatigue and ibd


Patterns of energy use
Patterns of energy use

  • Demonstration of boom and bust


Pacing and grading
Pacing and grading

  • Pacing activities across the day to minimise energy use

  • Intersperse activity with frequent rest

  • Know when to stop – stopping distances

  • Need to break activities down into smaller parts to make them easier

  • Mix and match


Fatigue and ibd


Managing energy
Managing energy

  • Look at ways at either reducing demand or improving supply


Improving supply
Improving supply

  • Need to look at increasing activities that are fun or give a sense of achievement

  • Ignore the guilt!


Decreasing demand
Decreasing demand

  • Demands from family, work, running a house etc

  • Also come from pressure of meeting own standards or expectations

  • May need to ask for help

    • Work

    • Professional

    • Financial support and benefits

    • Self management programmes


Managing sleep
Managing sleep

  • Practise good sleep hygiene

  • set routine

  • get up if cant sleep

  • Manage environmental factors (noise, light, have change of clothes or bedding at hand etc)

  • Exercise (not too late)


Sleep
Sleep

  • Write down troubling thoughts

  • Carry out relaxing activities

  • Avoid caffeine and alcohol

  • Don’t use computer or TV in bed

  • Avoid napping in day

  • Avoid looking at the clock


Improving energy
Improving energy

  • Keep active and consider exercise

  • Consider diet

  • Don’t stop doing activities you enjoy although may have to modify

  • Prioritise tasks but be realistic ie don’t take on too much

  • Plan your week to allow rest periods


Fatigue and ibd

  • Set simple realistic goals

  • Minimise stress

  • Practise relaxation

  • Consider learning breathing techniques, mindfulness, yoga, relaxation CDs etc.



Where to access help
Where to access help?

  • If you feel you are in need of help for any aspect of your mental health you can access counselling and therapy services through your GP. Just visit them and ask to be referred

  • If you feel you are not coping with IBD at all and would like help – liaison psychiatry can be accessed through your local IBD nurse