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The need for nocturnal bowel movements. Crohn’s diseases can cause sudden, frequent bowel movements, even in the middle of the night, which will prevent you from getting a restful night’s sleep.
The persistence of symptoms such as abdominal pain. Cramping and bloating can make it hard to fall asleep. “Sometime it’s just a matter of trying to get comfortable enough to fall asleep and stay asleep throughout the night,” Domilici says.

Blood loss. Slow continuous blood loss from lesions in the small or large intestine can lead to anemia, which causes fatigue explains Cuckoo Choudhary, MD, an associate professor of gastroenterology in practice at Jefferson University Hospitals in Philadelphia. One telltale sign of Crohn’s-related anemia is blood in the stool — call your physician right away if this happens.
Nutrient deficiency. As with many digestive conditions, Crohn’s disease can keep patients from properly absorbing key nutrients, such as iron, particularly when the small bowel is affected. A research review published in February 2015 in BioMed Research International maintains that low vitamin D levels (a vitamin that comes from sunlight and food sources) is associated with Crohn’s disease, and that vitamin D supplementation may have a therapeutic role.

Medication side effects. In addition to her symptom-related fatigue, Domilici remembers one particular medication that worsened the problem. “I felt like I’d been run over by a truck,” she recalls. Unable to get up for work in the mornings, she called her doctor for a switch. "Some medications can make patients anemic,” Choudhary says. If this is the case, you doctor may stop or switch your medications to address this problem or recommend supplements.
Depression. Like many others with chronic illnesses, people with Crohn’s disease symptoms are at increased risk for depression. This may be particularly problematic when people are first diagnosed, says Domilici, adding that living with Crohn’s for 31 years has helped her to gain some perspective and discover strategies to cope with the emotional and psychological challenges.