IBS and fatigue

Medical Q&A [Moderated]
1

Hi guys,

I was wondering if you had any experience relating to IBS (mixed in my case) and fatigue?

I have read that it is very common to have “extreme fatigue” if you have IBS (around 60% in women according to this study)

From what I understand the pathway that causes this isn’t fully understood, but may be caused by inflammation in the gut. *

I’ve read that ketotifen may help with this for individuals with IBS D… is this something suitable for IBS mixed and IBS C?

I understand it works by stabilising mast cells, does one have to be permanently be on this medication, or is it a case of once the mast cells are regulated, they stay regulated?

Have you guys got any other tips to manage IBS, such as probiotics and increasing fibre?

I have tried various elimination diets to try and pinpoint specific foods that causes flair ups, but it seems that no matter what I eat, I tend to get bad gas and bowl movements.

My doctors keep prescribing me with medicine such as hyoscine hydrobromide & Mebeverine to deal with the symptoms, but nothing to fight the cause.

I am also dealing with extreme fatigue, I’ve been tested for sleep apnoea, but only have a mild case of it, which my doctor says shouldn’t cause the level of fatigue I am feeling. I currently feel like i am sleeping fine and uninterrupted until my morning alarm, however i spend all day feeling tired and on weekends tend to sleep in (10+ hours) as i feel too tired to get out of bed. (I have kept consistent sleep and wake times in the past, but with no success in dealing with the fatigue).
Looking back, i believe the fatigue started around the time i got diagnosed with IBS, which has lead me down this rabbit hole.

I would love to hear your guys thoughts on this. Also, any opinions on Rifaximin? I don’t fully understand it.

Many thanks
T

*I’ve also read that anaemia may be the issue of this, but I’ve left this on the back burner for now, as I have a healthy diet, and I’m not loosing weight leading me to believe I should be fine absorption wise?

2

Irritable bowel syndrome commonly co-occurs with other things such as fatigue, as well as mood disorders (anxiety, depression, etc.). However, IBS is not characterized by significant inflammation in the gut, nor does it cause malabsorption or anemia. If there is evidence of inflammation or anemia, we look towards other causes including inflammatory bowel disease and other issues.

I do not have experience prescribing ketotifen for this situation and cannot comment on that, unfortunately. You say that your doctors are prescribing you with medicines to deal with the symptoms, but nothing to fight the cause – there is no single identifiable “cause” of this condition that has been established, unfortunately. A good overview of IBS management and additional resources from the clinical standpoint can be found here. Working with a dietician who has experience/expertise in IBS would be a good idea.

Fatigue is an extremely broad, general symptom that can be caused by numerous things. The evaluation and diagnosis of fatigue for a given individual is unfortunately outside the scope of what we can do via this forum, as it requires more in-depth consultation, as you would with a physician.