Inflammatory bowel disease (IBD), Anxiety and Fatigue.

If you’re living with inflammatory bowel disease (IBD) you’ll know it’s more than just a gut issue. You’ve probably been told to avoid flare triggers, stick to a low-residue diet, take your medication, and that someday you might need surgery. There is little su[[prt for the other side of IBD, symptoms like feeling exhausted, anxious or burnt out even when your symptoms are considered under control.

As a nutritionist who’s worked closely with people with inflammatory bowel disease, I’ve seen just how much this condition can affect your emotional health, energy and your day-to-day quality of life. However, there’s a lot we can do with functional nutrition to support your gut, your immune system and your energy and mental health too.

The gut/brain connection.

The gut-brain connection get s a lot of attention at the moment. It is a bi-directional conversation between your digestive system and your brain, mostly via the vagus nerve, but there are a few other mechanisms that can also influence this. When your gut is inflamed, like it is in IBD, that communication can affect mental health, producing symptoms of anxiety or low mood.

You can experience low mood, anxiety, brain fog or sleep issues even when not experiencing a flare-up of IBD. Chronic gut inflammation affects how neurotransmitters like serotonin are produced and regulated and it can also send your nervous system into a constant state of high alert. This in itself is very demanding of the body, leading to fatigue and exhaustion.

The role of gut dysbiosis

Inside your gut lives an entire ecosystem of microbes, some helpful, some not so much. In IBD, this delicate balance can be disrupted. On stool tests, I often see low levels of beneficial bacteria like Faecalibacterium prausnitzii and Roseburia, along with higher levels of inflammatory troublemakers like E. coli and Ruminococcus gnavus.

When this happens, your body produces fewer short-chain fatty acids (SCFAs), like butyrate. These SCFAs are vital for keeping inflammation down, supporting your gut lining and calming the gut-brain connection. Without them, things can spiral, leaving you more prone to flare-ups, brain fog, and mental health issues.

Nutrient depletion in IBD.

You can be doing all the right things and still feel depleted. That’s because IBD often affects how well your body absorbs nutrients. An immune system in overdrive will also contribute to nutrient depletion. Nutrients that affect our mental health are particularly vulnerable. For example, magnesium is often lost through diarrhoea or stress and low levels can leave you feeling anxious, restless or struggling to switch off at night. B12, folate and B6 are critical for energy, brain function and mood and these can be affected when the small intestine isn’t absorbing properly. Low zinc can make your gut more reactive and affect your stress tolerance and is commonly low in both auto-immunity and gut issues.

What about iron?

Iron is one of the few nutrients GPs will often test for. This is necessary as blood loss in IBD can lead to iron deficiency anaemia which will severely affect your energy levels. But more iron isn’t always better. High-dose iron supplements can be hard on the gut, causing constipation, cramping or even triggering a flare. They can also block the absorption of other key nutrients and could contribute to increased oxidative stress, which then leads to increased inflammation. A gentler targeted approach might be needed to increase iron without the disruption.

Supporting the gut-immune connection

Around 70–80% of your immune system sits in your gut. So when we support gut health with the right foods, nutrients, and microbiome balance we’re helping the immune system calm down and do its job better. This is the key to managing IBD long-term.

Using nutritional tools we can focus on reducing immune overactivity, soothe the gut lining and support the growth of beneficial microbes. As well as managing absorption issues and identifying any nutrient deficiencies. Real lasting change occurs when we shift the internal environment.

Not just symptom management.

When clients come to me, they’re often exhausted and tired of managing symptoms. They are tired of wondering what to eat and feel like their body is working against them. Sometimes they have developed anxiety or mood issues and don’t always realise that this could be related to nutrient deficiencies and gut inflammation.

Together, we work on a plan that’s realistic, supportive, and completely personalised. We go beyond food diaries and gut-friendly recipes. We look at any test results, health history, assess nutrient status, microbiome data (if needed), and build something sustainable and effective.

If you’ve been living with IBD and you’re ready for a different approach, I’d love to help.

Book an appointment and let’s work together to calm inflammation, correct nutrient imbalances, and help you feel more like yourself again.