Fatigue after bowel movement

Sleep difficulties are common in people with irritable bowel syndrome (IBS), as well as other gastrointestinal disorders including gastroesophageal reflux disease. Lethargy and daytime fatigue, which are common side effects of sleep disturbances, seem to also be common.

People with chronic pain report sleep as their number one problem. Certainly, abdominal pain, and pain from any source, can cause difficulty sleeping as well as arousals from sleep and consequent sleep fragmentation .

Learn More: Treating Pain in IBS

How to improve sleep

While there are a variety of medications that help improve sleep temporarily, most (with the exception of some of the antidepressant medications) are not useful on a chronic basis.

Keeping good sleep hygiene is critical for anyone with sleep problems. This includes:

  • having a period of time of relaxation before going to bed;
  • keeping a specific wake up time even if you did not sleep well during the night;
  • not staying in bed for more than 20 minutes without sleeping (get up and do something relaxing until you feel sleepy again);
  • turning the clock away so when you awake you cannot focus on the time;
  • using the bed only for sleep (or sexual activity) and not for reading, watching TV, or eating;
  • and avoiding food or drinks with caffeine for at least 4 hours before bedtime.

Daytime activities also affect sleep, so regular exercise and avoidance of napping can greatly improve nighttime sleep.

Unfortunately, it is safe to say that the average doctor does not necessarily ask about sleep disturbance in patients with functional bowel disorders, and patients may not mention them to their treating physician.

Be sure to let your doctor know if your IBS symptoms are disturbing your sleep. Treatment for sleep disturbance will likely improve your overall quality of life.

Did This Article Help You?

IFFGD is a nonprofit education and research organization. Our mission is to inform, assist, and support people affected by gastrointestinal disorders.

Our original content is authored specifically for IFFGD readers, in response to your questions and concerns.

If you found this article helpful, please consider supporting IFFGD with a small tax- deductible donation.

Adapted from IFFGD Publication #140 by Bruce D. Naliboff, PhD, Clinical Professor of Medical Psychology in the Dept. of Psychiatry and Biobehavioral Sciences, UCLA School of Medicine; Co-director, UCLA Center for Integrative Medicine; and Chief of the Psychophysiology Research Laboratory, West Los Angeles VA GLA Health Care; and from IFFGD Publication #178by William C. Orr, PhD, Lynn Health Science Institute, Clinical Professor of Medicine, University of Oklahoma Health Science Center, Oklahoma City, OK.

FRIDAY, July 15, 2016 (HealthDay News) — Chronic fatigue syndrome — a condition that continues to baffle doctors — may be influenced by a person’s intestinal bacteria — sometimes called gut microbiome, new research finds.

“Patients with chronic fatigue syndrome have a different profile of bacterial species in their gut microbiome than healthy individuals,” said the study’s senior author, Maureen Hanson. She’s a professor of molecular biology and genetics at Cornell University, in Ithaca, N.Y.

In the small study, she and her colleagues found that people with chronic fatigue syndrome had less diversity or different types of bacteria, compared to healthy people without chronic fatigue syndrome. People with chronic fatigue syndrome also had more species of bacteria that promote inflammation and fewer bacteria that dampen inflammation, the researchers found.

The new findings provide evidence to refute what Hanson calls “the ridiculous concept that the disease is psychological in origin.” For years, she said, some have suggested that chronic fatigue syndrome is simply psychological and can be helped by therapy. Not so, she said.

Even so, “I would not say we found the cause,” Hanson said. Rather, her team has found “another biological abnormality.”

Not everyone with chronic fatigue syndrome has the skewed microbiome, she said. Some of the study volunteers had fairly normal microbiomes.

Between 1 million and 4 million Americans have chronic fatigue syndrome, also known as myalgic encephalomyelitis, according to the U.S. Centers for Disease Control and Prevention. But only about 20 percent of people with the condition have been diagnosed. Symptoms may include overwhelming fatigue not helped by rest, sleep that is not restorative, malaise, joint and muscle pain, headaches and gastrointestinal problems such as irritable bowel syndrome.

In the study, the Cornell researchers evaluated 48 people diagnosed with chronic fatigue syndrome and 39 healthy controls. All provided stool and blood samples. The researchers tested stool samples for bacterial DNA. In chronic fatigue syndrome patients they found bacterial profiles with less diversity. This is similar to those seen in people with two bowel diseases: Crohn’s disease and ulcerative colitis, the researchers said.

About Fatigue and Digestive Problems

Fatigue is one of those nebulous issues which most people will encounter at some point in their lives. It’s easy to write off feeling tired and fatigued as just being a sign of getting older, being stressed, or being over-worked. While those issues can lead to fatigue, there is sometimes an underlying issue or a cause that is less obvious. For some people, it is their digestive health that is contributing to their fatigue.

People who suffer from irritable bowel syndrome (IBS) may be more likely to suffer from chronic fatigue, for example. This is because IBS can lead to gut inflammation, and that inflammation is thought to contribute to fatigue.1

There is a growing body of evidence that gut flora, the immune system, and the mucosal barrier in the gut are all linked. Having a lot of “good” gut bacteria will make you feel better. Allowing the less useful gut bacteria to become dominant can leave you feeling tired, drained, moody and generally unwell, as well as craving junk food. Of course, if you give in to those cravings, then you will likely end up feeling even worse. It’s a vicious cycle that can be hard to get out of.

The Effects of Digestive Health on Overall Well-Being

The digestive system is incredibly complex.2 The issue with the digestive system is that when it is working well, many people forget how important it is. Even when things start to break down, sometimes the side-effects are not immediate stomach aches or constipation, so it’s all too easy to forget that what you eat has a significant impact on how you feel.

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Fatigue can mean anything from constant low-level tiredness to far more serious issues such as myalgic encephalomyelitis (ME) or chronic fatigue syndrome. This condition is not something that is well understood, and a lot of the people who suffer from it develop it after having suffered from a serious infection. The latest research suggests that the gut microbiota in CFS sufferers could be the culprit, and this is plausible since a person’s gut microbiota can be changed as a result of taking antibiotics or having serious diarrhea.3 Fixing those digestive issues could help boost an individual’s energy levels.

Not all cases of fatigue are as severe or clear-cut as ME, however. Many people who are suffering from irritable bowel syndrome (IBS) also report feeling general fatigue. Indeed, this is the third most common “non-digestive” complaint of IBS sufferers.4 Researchers do not know what the cause of this fatigue is, however, there are several theories. The fatigue could be caused by poor absorption of nutrients, general stress and other side-effects of IBS, or the persistent inflammation characteristic of IBS.5

Managing Fatigue and Digestive Issues

If you are struggling with fatigue and think that it could be caused by issues with your digestion, then there are a few simple lifestyle changes that you could make to improve your quality of life. Before you start investigating such changes, be sure to talk to your doctor, especially if the fatigue or digestive issues are interfering with your day-to-day life. It will give you peace of mind that there are no underlying medical conditions to worry about.

Once you have been given the all-clear from your doctor, you should look at basic lifestyle changes that could give you more energy. First, remember that your digestive system is a complex machine and that you need some basic nutrients to stay healthy. Two key factors for your overall gut health are hydration and fiber.6 Drinking lots of water and eating complex carbohydrates and high-quality fiber sources (whole grains, bran, etc.) and avoiding simple carbohydrates and artificial sweeteners can improve your gut health.

Diet is just one part of your overall health, however. Regular exercise can help with your digestive system, as can taking steps to reduce and manage stress. Stress has a significant impact on your overall health, and the link between the gut and the brain is close enough that some people call the gut the “second brain.” 7

Reducing stress through meditation, exercise, cognitive behavioral therapy (CBT), yoga, and aromatherapy could help improve your digestive health and consequently help combat fatigue.

Studies show that aromatherapy can help reduce fatigue and can make other methods of relaxation more effective, even for people who are going through stressful periods or significant life changes, such as mothers who have just given birth.8 Researchers have also found some promising evidence of the impact of essential oils when it comes to intestinal health in animals.9

For the relaxation benefits of aromatherapy, try using essential oils topically after diluting them with a carrier oil, in a bath, or aromatically in a room diffuser or personal diffuser like Zen.


It’s important to remember that the gut microbiome is always changing. If you eat a diet that is high in sugars and processed food, then your gut microbiome will reflect that. If you eat more fruits and vegetables, then your gut microbiome will change to one that thrives on that diet.

You can’t simply take probiotics as if they are medicine and attend some yoga classes while trying aromatherapy for a week or two, then get back to your old routine when you feel better. The changes you make to our routine to restore digestive health need to be long-lasting.

Gut health can change everything down to your circadian rhythm.10 If you take steps to improve your gut health, you should quickly notice that you have more energy, feel “lighter” and healthier, are less bloated, sleep better, and have more mental clarity. Once you experience those benefits, try not to get complacent. Keep up with the good habits that produce that feeling so that you can keep it for many years to come.


Addison’s disease

Later symptoms

Further symptoms of Addison’s disease tend to develop gradually over months or years. However, additional stress, caused by another illness or an accident, for example, may cause your symptoms to suddenly get worse.

You may go on to develop:

  • low blood pressure when you stand up, which can cause dizziness and fainting
  • nausea (feeling sick)
  • vomiting (being sick)
  • diarrhoea
  • abdominal, joint or back pain
  • muscle cramps
  • chronic exhaustion, which may cause depression
  • brownish discolouration of the skin, lips and gums (hyperpigmentation), particularly in the creases on your palms, on scars or on pressure points, such as your knuckles or knees
  • a lack of interest in sex (reduced libido), particularly in women

Some women may also have irregular periods or miss some periods completely. Children with Addison’s disease may go through puberty later than usual.

Some people with Addison’s disease also develop low blood sugar (hypoglycaemia). This can cause symptoms such as difficulty concentrating, confusion, anxiety and even unconsciousness (particularly in children).

If you’re experiencing symptoms of Addison’s disease, see your GP so they can diagnose or rule out the condition. These symptoms will usually improve with appropriate treatment.

Read more about diagnosing Addison’s disease and treating Addison’s disease.

IBS, Meet CFS: The Link Between Irritable Bowel and Chronic Fatigue Syndrome

Irritable bowel syndrome and chronic fatigue syndrome frequently coexist. Separately, each presents challenges, but together they can be a double-whammy to your quality of life. And because the cause of each remains a bit of a mystery, so too does the reason as to why they often appear together.

Studies indicate that many things lead to the development of irritable bowel syndrome (IBS) and chronic fatigue syndrome. Researchers who look at factors that the conditions share have come up with several theories based on scientific evidence that could explain why they often coexist — including infection, immune problems, and heightened pain perception, among others. But scientists have yet to pinpoint one common denominator.

“These are complex conditions — that’s why it’s so hard to say that there is one blood or other type of medical test that’s going to diagnose these syndromes,” says Lin Chang, MD, director of the Digestive Health and Nutrition Clinic and a professor of medicine at the David Geffen School of Medicine at UCLA. “They are both multi-factorial.”

Understanding the Two Conditions

With IBS, your bowels stop working the way they should, causing abdominal pain and a change in bowel habits — like diarrhea, constipation, or both. To get a diagnosis, you must experience abdominal pain at least three times a month for three months. IBS is called a functional bowel disorder, meaning there’s no known anatomical problem, like cancer or colitis, in the intestines.

With chronic fatigue syndrome, you’re more than just tired. You have an unexplained, persistent fatigue that lasts for at least six months and isn’t helped by rest. Since there’s no test to diagnose it, doctors rely on symptoms to make a determination. Aside from fatigue, you also need to have at least four of the following symptoms to be diagnosed with chronic fatigue:

  • Feeling unwell for more than a day after physical activity
  • Muscle pain
  • Headaches
  • Memory problems
  • Joint pain
  • Sleep disturbances
  • Sore throat
  • Tender lymph nodes

These symptoms can resemble those of other diseases or conditions, so first your doctor will need to rule out other causes before making a definitive diagnosis of chronic fatigue syndrome. Some people with chronic fatigue can carry on life with some limitations, but about 25 percent are fully disabled by the condition.

It’s also important to note that both chronic fatigue and IBS are diagnosed more often in women than men in the United States.

Chronic Fatigue and IBS: What’s the Link?

So what’s the connection? Dr. Chang says that many factors may contribute to the development of both conditions. Here are some possible scenarios:

Post-infectious syndromes. IBS sometimes develops after a stomach bug or food poisoning, says Chang. Likewise, chronic fatigue syndrome has been seen in people after a bacterial, viral, or parasitic infection. “In fact, in chronic fatigue, one of the biggest theories is that some sort of infection is causing the symptoms,” she says.

A study from Norway linked Giardia infection, or giardiasis, with both the development of IBS and chronic fatigue. Published in the journal Gut in 2011, the study tracked what happened after the parasite got into the water supply in Bergen, Norway, in 2004, causing diarrhea, stomach pain, and other intestinal problems. The researchers followed more than 800 people who recovered from the infection and compared their health with that of people who had not been infected. Three years after the illness, 46 percent of the infected group had developed IBS symptoms, compared with 14 percent of those who hadn’t been infected. Chronic fatigue also was reported by about 46 percent of people who’d had giardiasis, compared with 12 percent of the others. About 7 percent of the infected group got both conditions.

Overactive immune response. In IBS, scientists theorize that an immune response in the gut could trigger changes in secretions or the way the bowel moves or senses pain, causing symptoms, says Chang. In chronic fatigue, she says, a problem in the immune system could cause production of inflammatory substances that are linked to fatigue.

Enhanced pain perception. People with IBS and possibly those with chronic fatigue syndrome tend to process pain differently than people without the conditions. Chang explains it this way: “Say I have IBS or another chronic pain condition and you don’t, and someone applies intense pressure to our thumbnails. At the same pressure, I’ll feel it as a much more intense pain. I will rate it as 8 out of 10, and you’ll rate it as 2 out of 10. The pressure threshold that I feel pain will be lower than yours.” In IBS, the increased sensitivity occurs mainly in the bowels.

Genetic predisposition. Researchers also are looking at whether gene variations make people more vulnerable to getting IBS, chronic fatigue, or another functional syndrome.

Environmental factors including stress from losing a job or caring for a sick parent also could contribute to the development of these conditions or trigger a flare, Chang says. “It’s possible that the combination of chronic stress and a certain genetic type would predispose an individual to getting IBS and chronic fatigue syndrome,” she adds.

Treating Chronic Fatigue Syndrome and IBS

When IBS and chronic fatigue overlap, you may face a unique set of challenges. “You have to treat multiple symptoms, and patients have a harder time managing their symptoms because it’s overwhelming sometimes,” says Chang. In addition to specific symptom treatments, Chang uses interventions that she says are useful for both conditions:

  • Cognitive behavioral therapy. Talk therapy can give you tools to manage your condition, provide you some sense of control, and help you feel less overwhelmed.
  • Medications that reduce pain. Talk to your doctor about what medications may help reduce the pain from both conditions.
  • Lifestyle changes. Having routine activities and daily structure and not overexerting yourself can help ease symptoms of both IBS and chronic fatigue.

Chang adds that improving mood and sleep will go a long way toward improving both conditions as well.

IBS and fatigue

An introduction to IBS and fatigue

Experiencing low energy levels and, in extreme cases, fatigue, are unfortunately common issues for Irritable Bowel Syndrome (IBS) sufferers. Fatigue is described as extreme physical and/or mental exhaustion which can be the result of illness, stress, medication or a combination of these factors.

Why does IBS cause fatigue?

The digestive system, more specifically the small intestine wall, is a major site for absorption of food and nutrients into the body. If this isn’t working properly, consequences result.

For example, if not enough essential vitamins and minerals are absorbed our energy levels will decrease. This is especially so if diarrhoea is present and food does not stay in your gut for any length of time.

In addition to this, our bowel contains billions of ‘good’ bacteria. These produce a number of nutrients, including the B group of vitamins essential for converting our food into energy. If this process is disrupted our energy levels may suffer.

Another possibility may be that ‘bad’ bacteria or pathogens appear unwanted and are absorbed through the gut wall, which can put the immune system under huge pressure, resulting in fatigue. Chronic fatigue syndrome has been known to appear in people after they have suffered from a bacterial or viral infection.

Sleep disturbances are also linked with IBS and sleeping badly can have an impact on energy levels during the day.

What can I try at home for fatigue?

There are a few simple techniques which may help to counteract the feeling of extreme tiredness or fatigue:

  • Eat right: Eat a colourful, varied and nutrient packed diet to benefit from as many vitamins and minerals as possible. The B vitamins which support the conversion of food into energy are present in many wholefoods such as fish, legumes and wholegrains
  • Get enough sleep: Up to 8 hours sleep per night will give you the best chance of feeling energised the following day. Watch our video on What is good sleep? to gain a better insight
  • Exercise: Strange as it may seem, exercise can help combat fatigue. Physical activity encourages increased blood flow, increasing the amount of oxygen and vital nutrients being delivered to the tissues of our body, which assists in the process of energy production.

How can natural remedies help me?

Supporting your digestive system will give you the best chance of absorbing the vitamins and minerals we require to feel energetic.

  • Digestive bitters: Use digestive bitters before a meal to support the digestive process – this class of herb stimulates the release of gastric juices and enzymes, helping to ensure adequate breakdown of food in the stomach before reaching the small intestine
  • Tormentil: The herb Tormentil may help to relax gut contractions in the case of diarrhoea allowing for an increased absorption of vitamins and minerals
  • Molkosan: Finally, take Molkosan daily which works well to create an environment to support the good bacteria in our gut. Beneficial good bacteria, also known as microflora, are able to produce B vitamins in the gut – useful for generating energy
  • Balance Mineral Drink: This fatigue-fighting drink contains magnesium, which is vital for energy levels. It also contains potassium, calcium, vitamin D and zinc to support overall health. Read more about Balance Mineral Drink.

How can my doctor help?

If you experience any unexplained bouts of tiredness or fatigue your doctor should investigate it, especially if the symptoms linger or become more persistent. They will be able to run blood tests and other examinations to determine if there is any other explanation for your fatigue. This will be the first step towards finding the right treatment for you.

Is it common for IBS symptoms to return after a person has been symptom-free for over a year? IBS is best thought of as a life-long disorder, just like migraine or asthma. You will always be predisposed to abdominal (tummy) problems but that doesn’t mean to say they will be there all the time. Your tummy is your “‘weak spot,” so that is the area that will likely suffer first for instance when you are ill, eat the wrong thing, or are otherwise stressed. Many patients find it frustrating that they can’t identify why they are having a bad time. It is perhaps best not to try too hard to find the reason as there are probably lots of triggers that we don’t even know about yet.

The symptoms of irritable bowel syndrome (IBS) can be hard to manage. Symptom episodes may continue to interfere with normal activities well after an initial diagnosis and treatment. That can be discouraging and a cause of worry. It’s reassuring to know that having IBS does not put you at an increased risk of developing other digestive disorders or diseases.

Learn more about the symptoms of IBS

Despite this, there are times when it may be best for your doctor to review your symptoms and how they affect you. Here are suggestions for when to seek additional guidance from a medical professional.

Developments of Concern

Wrong beliefs about IBS may lead to distress, more doctor visits, and unneeded tests. It helps to know, IBS:

  • Does not cause physical damage
    • Does not increase the risk of colon cancer, inflammatory bowel disease, diverticulitis, or other gut disorders

On the other hand, neither does IBS protect you from acquiring these conditions. It also can coexist with another disorder.

Two situations provide alerts that another disease might be present:

  • The presence of an “alarm” symptom
  • Increased personal risk

Alarm Symptoms – An “alarm” symptom, sometimes also called a “red flag,” simply means a symptom not explained by IBS, which calls for additional investigation. These are symptoms and signs of an underlying disease that physically damages the gut.

Sometimes the most alarming of such symptoms, namely bleeding, turns out to be un-alarming after all, but you should always let your doctor know. Small amounts of bright red blood usually turns out to be from a hemorrhoid or small tear (fissure) in the anal passage. Rarely, it could be due to another condition that requires treatment. On the other hand, large amounts of red blood or black, tarry colored stool calls for urgent medical attention.

Here are some typical signs that call for special attention:

  • New symptom onset at age of 50 or older
  • Blood in the stools
  • Nighttime symptoms that wake you up
  • Unintentional weight loss
  • Change in your typical IBS symptoms (like new and different pain)
  • Recent use of antibiotics
  • Family history of other GI diseases, like cancer, inflammatory bowel disease, or celiac disease

Increased Personal Risk – Sometimes there is a factor in your life that may put you at greater than average risk of acquiring a serious intestinal disease. For example, if a parent or sibling has had colon cancer or even a precancerous colonic polyp, then your risk of polyps is greater than normal. Inflammatory bowel disease (ulcerative colitis and Crohn’s disease) tends to occur in families. Celiac disease, where essential nutrients fail to be absorbed, has its greatest prevalence among the descendents of people born in Northern Europe.

IBS patients are as likely as anyone to suffer an intestinal infection, which may add to and confuse the symptoms. You should be suspicious of an infection if:

  • You have been traveling to tropical or developing parts of the world
  • Friends and family are infected
  • You have been exposed to possibly contaminated drinking water

Let your doctor know about any of these concerns.

When to See your Doctor

IBS follows an unpredictable course. There may be periods of relative calm, mixed back and forth with periods of pain or discomfort and chaotic bowel habit that interfere with your life. However, if the basic pattern of your bowel symptoms changes, or one of the situations described above occur, a visit to your doctor is in order.

Sometimes a drug you are taking for another purpose or something new in your diet may be responsible for the change, and your doctor can help you determine that. A visit also provides your doctor with the opportunity to review your diet, exercise habits, and drug regimen, and perhaps recommend changes.

Learn more about working with your physician

Putting it all Together

IBS is long-term (chronic) and tends to repeatedly come and go over time. It does not predispose you to other GI disease. However, IBS does not protect you from the new onset of other disease. New and different symptoms may make you suspicious that something new is happening.

You should visit your doctor if you become aware of alarm symptoms or of a factor that might put you more than normally at risk of another disease. Your doctor may review your symptoms and perhaps perform certain tests.

Usually, if the original diagnosis was sound, recurrent, but similar symptoms do not signify a new disease.

Did This Article Help You?

IFFGD is a nonprofit education and research organization. Our mission is to inform, assist, and support people affected by gastrointestinal disorders.

Our original content is authored specifically for IFFGD readers, in response to your questions and concerns.

If you found this article helpful, please consider supporting IFFGD with a small tax- deductible donation.

Resource: Adapted from IFFGD Publication: Changes You Should Not Ignore if You Have IBS by W. Grant Thompson, MD, FRCPC, Emeritus Professor of Medicine, University of Ottawa, Ontario, Canada, and an article published in Digestive Health Matters, Vol. 16, No. 1 by Peter Whorwell, MD, Professor of Medicine and Gastroenterology, University of Manchester, Manchester, United Kingdom.

Anyone else feel horrible fatigue after pooping?

So, I am definitely not a doctor, but you may want to look up a couple things to see if the symptoms fit, namely dysautonomia, and more specifically, vasovagal syncope. I’ve never been formally diagnosed with either, but after having a few episodes over the years, and comparing notes with family members that have had similar episodes, I think i’ve been able to figure out what’s going on with my body, and i’m fairly confident that i’ve had some mix of the above happening off-and-on over the years.

With my body, I don’t get super-exhausted with average poops, and I may even go weeks or a month or two without an episode. But for me, if I ever get kinda backed up where I’m kinda constipated and I have a fairly significant bowel movement, apparently that can stimulate the vagus nerve a bit. My vagus nerve apparently is a bit sensitive, and I’ve had a few bouts of fainting or nearly fainting from stimuli like this or other things that can apparently make it act up. Fainting / near fainting is rare for me, but normally I’ll just feel super drained for a while if I have a tough bowel movement, then I’ll bounce back after a couple hours.

Start keeping notes and see if you seem to be consistently more or less tired after bowel movements that are easier / more difficult, see if the symptoms line up with the things I mentioned above, and if so, you may want to mention it too your doctor… Dysautonomia is not exactly a common thing, so you may have difficulty locating a doctor that can diagnose it properly, but for most people I don’t believe it’s a serious issue, it’s just an annoying thing (at least for me it seems to be). Good luck!

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