Ulcerative colitis and fatigue: What is the link?

Ulcerative colitis is a form of inflammatory bowel disease (IBD) that causes inflammation in the colon. The other common form of IBD is Crohn’s disease.
Fatigue occurs when a person feels overwhelmingly tired or lacking in energy. A person with ulcerative colitis, regardless of their age, may experience fatigue as a symptom of the condition.
Several factors associated with ulcerative colitis — including disease activity, psychological stress, and medication — can cause a person to experience fatigue.
This article covers what researchers currently know about the connection between ulcerative colitis and fatigue.
What is fatigue?
Fatigue is a feeling of overwhelming tiredness or low energy. A person with fatigue may describe what they are feeling as exhaustion. Fatigue can occur even if a person gets an adequate amount of sleep.
can occur
Several conditions and factors can cause fatigue. In some cases, fatigue may be the result of disruptive sleep patterns or not getting enough physical activity. In other cases, conditions such as ulcerative colitis can cause fatigue.
Generally, a person may experience fatigue due to:
may experience
psychological conditions, such as stress, depression, or anxiety
certain medications
surgery side effects
How can ulcerative colitis cause fatigue?
Several aspects of ulcerative colitis can cause fatigue. For example, the Crohn’s and Colitis Foundation indicates that IBD can lead to fatigue because of:
Crohn’s and Colitis Foundation
arthritis, which is a common co-occurring condition with ulcerative colitis
inflammation
anemia
poor sleep
nutritional deficiencies
medication side effects
Fatigue is a common effect of these factors.
People with ulcerative colitis often have folate or vitamin B12 deficiencies.
Several medications to treat IBD — including AZA, 6-MP, methotrexate, antidepressants, narcotics, and steroids — can also cause fatigue.
One 2020 study looked at some of the potential causes of fatigue in people with IBD. The researchers noted some additional causes, including:
2020 study
changes in the gut microbiome
psychological conditions, such as depression
complications from active disease
persistence of active disease
Another study, this time from 2018, noted that females with ulcerative have a higher risk of experiencing fatigue. The researchers also noted that iron deficiency, which can lead to anemia, is also associated with ulcerative colitis-related fatigue.
Another study
In a 2019 study, researchers looked at how children with ulcerative colitis experienced fatigue.
2019 study
They found that, like adults, children with the condition can experience high levels of fatigue. They noted the following potential reasons for this:
disease activity level
medication side effects
a lack of family support
anxiety and depression
reduced physical activity and overall steps in a day
How common is fatigue as a symptom of UC?
According to the Crohn’s and Colitis Foundation, fatigue is a common issue among people with IBD. It affects 80% of people with active IBD and 50% of people in clinical remission.
Crohn’s and Colitis Foundation
Despite the frequency of fatigue in IBD, researchers have indicated that it is often underreported and undertreated. They have noted that doctors often do not treat fatigue because of the subjective nature of the condition.
have indicated
People with fatigue should talk with a doctor and make sure that they understand how much fatigue affects their life. The more information a person can provide about their symptoms, the more likely the doctor is to understand fatigue as a serious symptom and make recommendations for treatment.
How to treat and manage fatigue 
In addition to taking steps to manage and treat ulcerative colitis, a person can make certain lifestyle changes to help reduce fatigue.
Some potential ways for a person to improve fatigue and boost energy levels include:
Get regular exercise: Physical activities, such as playing sports, and exercise, such as walking or running, can help reduce symptoms.
Avoid smoking: Avoid smoking to improve symptoms of fatigue and to gain other positive health benefits.
Avoid long naps: A person who experiences fatigue should try to avoid taking naps that are longer than 30 minutes, particularly later in the day.
Ask for help: Asking others for assistance may help someone with ulcerative colitis manage work and other important tasks before fatigue sets in.
Keep track of when feelings of fatigue occur: A person can keep a record of times during the day when they feel the most tired. This can help determine what may be influencing their fatigue.
In one 2020 study, researchers found that the best way to treat fatigue is to treat its underlying causes.
2020 study
In the study, the researchers noted anemia, nutritional deficiencies, depression, and sleep disturbances as possible causes. They recommended that people work with a doctor to identify and treat any co-occurring conditions.
A 2021 study suggested that additional therapies are often necessary to address fatigue in people with ulcerative colitis. The researchers highlighted the need for more research on treatment in the future.
2021 study
The takeaway
Living with ulcerative colitis can cause a person to experience symptoms of fatigue. Fatigue is a debilitating feeling of being tired or lacking energy.
Ulcerative colitis can lead to fatigue in a variety of ways, including through treatment side effects, co-occurring conditions such as anemia, and other physical and psychological factors.
A person can take steps to combat fatigue through exercising, adjusting one’s sleep patterns, and managing both ulcerative colitis and other conditions.