7 Ways to Fight Fatigue From Ulcerative Colitis

by Tracy Davenport, Ph.D. Health Writer

If you’re living with ulcerative colitis (UC) and also battle chronic fatigue, know this: You’re definitely not alone. This inflammatory bowel disorder (IBD) affects 600,000 to 900,000 people in the U.S. It can leave you feeling like you lack energy, strength, concentration, alertness, and even motivation—or some combination of all of those things. However, there are simple things you can introduce into your routine to help get ahead of fatigue. Here, some top experts share tips for how to fight back—starting with an understanding of why fatigue is so common with this condition.

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UC Fatigue Has Many Sources

When it comes to UC and fatigue, “there are a number of contributing factors at play,” says Ashwin Ananthakrishnan, M.D., an associate professor of medicine at Massachusetts General Hospital and Harvard Medical School in Boston. “It is likely that different factors influence each other, so it may not be just one thing that is making you tired.” In other words, UC can come at you at once from multiple fronts. “Contributing factors may include inflammation; inadequate nutrition status, including iron deficiency; the role of depression; stress; impaired sleep; and other factors,” he explains.

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Fatigue Is Common Among All People With UC

Remember, it’s not just older folks or one biological gender who experience fatigue with ulcerative colitis. Recent research published in the Journal of Crohn’s and Colitis found more than 60% of people diagnosed with IBDs reported significant fatigue. In another study, lack of energy was the most burdensome symptom reported, even more than gastrointestinal complaints including diarrhea—which is often triggered by inflammation in the large intestine in people with UC. Though fatigue seems to impact more women than men with UC, it can occur in all ages and both sexes, per Advances in Therapy.

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Don’t Forget to Mention How Tired You Feel

With various factors at play, you’ll need to try a multi-pronged approach to fight fatigue. First, don’t forget to address your fatigue levels with your doctor at every appointment. With other possible symptoms to discuss it might not come up—so be sure to mention your energy levels. Your doctor can then review your medications to see if any might be draining you. Some medications used to treat UC (such as corticosteroids) can cause fatigue either directly or indirectly by disrupting sleep. Other medications that alter the immune system have also been reported to make people feel tired, per the Arthritis Foundation.

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Treat Inflammation to Beat Fatigue

According to Dr. Ananthakrishnan, if you’re feeling tired it’s important that inflammation in your body is being effectively treated. During a flare, the immune system mistakenly attacks the lining to the gastrointestinal tract, which leads to inflammation—and this is why you can feel exhausted. According to the Crohn’s & Colitis Foundation, chemical signals produced during inflammation can directly act on the brain to cause tiredness and a lack of energy. So treating inflammation flares with corticosteroids, immunosuppressants, or other therapies is a top priority. Talk to your doctor about which treatments are best for you.

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Eat for Maximum Energy

Diet may play a role in causing UC fatigue—especially if you’re not eating a balanced and broad diet, says Dr. Ananthakrishnan (which may include healthful Mediterranean diet recipes). Consuming low “FODMAP” foods (potatoes, eggs, tofu, and lean meats) can also help; so, too, can avoiding seeds, whole wheats, and lactose foods. While there are several specialized diets that may be helpful for some, no one plan has been proven to prevent or control UC, per the Crohn’s & Colitis Foundation. Your medical team may recommend a particular diet based on your symptoms and what foods you’re best able to tolerate.

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Avoid Sugar To Help Curb Inflammation

Refined sugar is not your friend if you have UC, according to Eleanor Baker, M.S., a registered dietician in Melbourne, FL. “Diets high in added sugar contribute to a spike in blood glucose that can result in a short-term increase in energy, and then a drop in energy levels as the body strives to keep up with the excessive intake of sugar.” Ms. Baker recommends eating foods with naturally occurring sugars (like fruit) and whole grains to provide you with a steady release of energy without the undesirable crash later. For a healthy treat try these low-sugar dessert recipes for people with UC.

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Don't Ignore Nutritional Deficiencies

“It’s important to get assessed for nutritional deficiencies and then treat them if they are present,” says Dr. Ananthakrishnan. Some of the most common nutritional deficiencies include iron, B12, vitamin D, vitamin K, folic acid, selenium, zinc, vitamin B6, and vitamin B1. There are many nutrient-rich foods that can help alleviate various deficiencies from UC, but flares or other complications may make it difficult to get enough nutrients from food alone. Your medical team may recommend supplementing your diet with vitamins or minerals.

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Exercise Combats UC Fatigue, Too

We get it: Feeling tired makes the sofa all the more appealing. But don’t take this lying down: Try a brisk walk around the block instead. Why? Incorporating even moderate regular physical activity into your daily routine can reduce fatigue, Dr. Ananthakrishnan says. Research backs him up: A 2020 review article in the American Journal of Gastroenterology, found that recreational exercise decreases the risk of flares and fatigue in people with IBDs. A different 2020 study reports that a 12-week personalized exercise program not only improved fatigue levels in folks with IBD, but also improved overall quality of life.

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Make Quality Sleep a Priority

There are many reasons that you may not be getting the rest you need, and your ulcerative colitis may be one of them. In fact, those with UC appear to experience worse quality of sleep in general, even when they’re in remission, according to a study published in the Journal of Clinical Medicine. However, when it comes to reducing inflammation, good, consistent sleep is your goal. Even a single night of getting just four hours of shuteye has been shown to increase inflammation. When you’re short on ZZZs, try these smart UC sleep tips to send you into slumberland.

Tracy Davenport, Ph.D.
Meet Our Writer
Tracy Davenport, Ph.D.

Davenport is the founder of Tracyshealthyliving.com. Using the latest scientific research, she helps people live their healthiest lives via one-on-one coaching, corporate talks, and sharing the more than 1,000 health-related articles she's authored.