Fatigue is one of the most common yet frequently overlooked symptoms of ulcerative colitis. While it may feel like ordinary tiredness at first, fatigue related to ulcerative colitis is often persistent, overwhelming, and not fully relieved by rest or sleep. It can interfere with daily life, affecting one’s ability to work, exercise, socialize, and manage routine tasks.
Understanding why fatigue occurs, recognizing its signs, and exploring ways to manage it are crucial for improving quality of life. With the right knowledge and support, you can take active steps to protect your energy levels and feel more in control of your health.
Can ulcerative colitis cause excessive tiredness or fatigue?
Yes, ulcerative colitis can cause significant and ongoing fatigue. Ulcerative colitis is a type of inflammatory bowel disease (IBD) that specifically affects the colon, and the inflammation itself plays a major role in low energy levels. When inflammation is ongoing, the body has a harder time absorbing essential nutrients needed for energy production, nerve function, and oxygen delivery in the blood.
At the same time, the immune system remains constantly active, releasing inflammatory chemicals called cytokines. These chemicals can make you feel worn out even if you’re resting enough. On top of that, symptoms like frequent bowel movements, abdominal cramping, and stomach pain take a physical toll and can disrupt your daily routine, steadily draining energy over time.
Addressing inflammation, supporting proper nutrition, and managing symptoms effectively can help reduce the impact of fatigue and make it easier to maintain daily activities.
Key factors behind exhaustion from ulcerative colitis
Ulcerative colitis can certainly make you feel tired, but it rarely has just one cause. Understanding the main contributors can help you and your healthcare team manage it more effectively.
Chronic inflammation
Fatigue is a well-recognized symptom of ulcerative colitis. A 2024 meta-analysis found that about 54% of people with active disease report fatigue, compared with roughly 33% of those in remission, showing that tiredness is more common during flares but can still occur even when symptoms are under control. Fatigue is typically observed in individuals with moderate to severe disease activity, depressive symptoms, and disrupted sleep patterns, such as nighttime bowel movements.
When inflammation and disease activity persist, the immune system stays in a heightened state of activity. This constant immune response uses up energy and can leave you feeling drained, even with ample rest. Over the long term, this constant strain can lead to long-lasting tiredness and low stamina.
Nutrient deficiencies
Ulcerative colitis can make it harder to maintain adequate nutrition due to reduced intake during flares, inflammation, and blood loss, leading to nutrient deficiencies that contribute to fatigue.
Iron deficiency is particularly common and may cause anemia, a condition in which the blood carries less oxygen throughout the body, making simple daily activities feel exhausting. Other nutrients — such as vitamin D, magnesium, zinc, selenium, and calcium — may also be deficient during UC flares also related to the inflammation, blood loss, reduced intake, and potentially medications. Since these nutrients do support nerve function, immune regulation, and overall energy levels it can also add to the fatigue.
Although vitamin B12 and folate deficiencies are more often associated with Crohn’s disease, another type of IBD, they can still occur in individuals with ulcerative colitis, depending on diet, medications, or disease activity. When present, these deficiencies may add to feelings of tiredness and reduced stamina.
Because fatigue in ulcerative colitis often has more than one cause, it’s a good idea for patients to talk with their healthcare provider about checking other possible contributors. Simple blood tests can look for signs of ongoing inflammation, such as C-reactive protein (CRP), or check how well the thyroid is working, since thyroid problems can also cause low energy.
Sleep disturbances and stress
Sleep problems are common in people with ulcerative colitis. Research suggests that about 60% of those with IBD experience sleep disturbances, although estimates can vary by how sleep disturbances are measured and defined. Symptoms like abdominal discomfort, urgency, or nighttime bowel movements can interrupt sleep, and issues may continue even when the disease is in remission.
Poor sleep makes fatigue worse by limiting the body’s ability to recover and regulate inflammation. Over time, ongoing sleep disruption has been linked to higher disease activity. Stress, anxiety, or depression — conditions that are more common in people with ulcerative colitis — can further interfere with sleep and make low energy levels harder to manage.
Medication side effects
Some medications used to treat ulcerative colitis can also affect energy levels. Corticosteroids, in particular, are often prescribed to control flares but aren’t intended for long-term use. When taken repeatedly or over extended periods, they can disrupt sleep, affect mood, reduce muscle strength, and alter metabolism, all of which may lead to fatigue — even when other ulcerative colitis symptoms are improving.
Pain relievers like nonsteroidal anti-inflammatory drugs (NSAIDs) are also used during flare-ups. While they don’t consistently trigger flares on their own, they’re often taken during periods of increased disease activity, which can make it harder to distinguish their effects from fatigue caused by inflammation itself.
Because fatigue can result from a combination of disease activity, medications, and overall health, discussing your symptoms with a healthcare provider might help. In some cases, treatment adjustments or steroid-sparing strategies may support better energy levels over time.
Common signs of ulcerative colitis-related exhaustion
Fatigue from ulcerative colitis feels very different from the usual tiredness at the end of the day. Many people notice a combination of physical and mental symptoms, including:
- Persistent feeling of tiredness even after a full night’s sleep
- “Brain fog” or difficulty keeping your focus at work, while reading, or even during conversations
- Exhaustion from simple activities like walking up stairs, carrying groceries, or completing your morning routine
- Energy dips at unexpected times throughout the day, sometimes feeling like you need a nap despite getting enough rest
Recognizing these patterns can help you understand that your energy levels may be linked to ulcerative colitis, not just a busy schedule.
5 practical ways to manage fatigue from ulcerative colitis
While each person’s experience with ulcerative colitis is unique, the following strategies can help boost energy and improve daily functioning.
1. Focus on a nutrient-rich diet
Since fatigue is often linked to nutrient gaps, prioritize foods rich in iron, vitamin B12, protein, and healthy fats to support energy levels. Work with a registered dietitian to ensure that you meet your nutritional needs, while adjusting intake according to your personal tolerance, especially during flares.
2. Prioritize sleep and rest
Good sleep helps the body recover and maintain steadier energy throughout the day. Aim for seven to nine hours of sleep each night and consider taking short daytime naps if needed.
3. Manage stress
Stress can amplify symptoms of ulcerative colitis, including fatigue. Use gentle activities such as stretching, light exercise, yoga, meditation, or brief breathing exercises to calm the nervous system. These can also help conserve energy and support overall well-being.
4. Track symptoms and energy
A simple record of meals, medications, symptoms, and daily energy levels makes it easier to identify patterns and triggers. Having this information readily available also keeps consultations with your healthcare provider much more productive.
5. Seek support from others
Managing ulcerative colitis–related fatigue can feel isolating, but you don’t have to manage it on your own. Connecting with healthcare professionals, family, or friends not only provides encouragement, but also guidance and accountability as you work toward recovery.
Let Health Loft guide you to a healthier, more energized routine
Managing ulcerative colitis means dealing with fatigue that feels persistent, but that doesn’t mean it has to be an inevitable part of your life. A thoughtful approach to food can make a real difference, especially when you work with a registered dietitian who understands ulcerative colitis. They can help you identify the foods your body handles best, craft balanced meals around them, and determine if any supplements might support your energy and overall health.
At Health Loft, we focus on designing nutrition strategies that specifically account for your symptoms, personal preferences, and daily routine. By partnering with a Health Loft dietitian, you gain hands-on guidance and support to rebuild your energy, improve your well-being, and feel more in control of your health.
This article was reviewed by Katie Whitson, RD, LD. It is intended for informational purposes only and does not replace personalized nutritional advice.
