According to a review published in 2020 in the journal Advances in Therapy, up to 47 percent of people with ulcerative colitis report having fatigue at the time of their diagnosis. Another study, published in March 2022 in the Scandinavian Journal of Gastroenterology, found that even people whose UC is in deep remission experience fatigue, which shows that it can be triggered by more than just inflammation. Although fatigue can seriously deplete your energy reserves, certain lifestyle changes can help you fight back. Here are eight strategies you can try.
1. Catch Some Z’s
A good night’s sleep can help you feel more rested throughout the day. “I try to sleep for at least 10 hours,” says Brooke Bogdan, 28, a public relations professional from Cleveland who was diagnosed with ulcerative colitis in 2013. “If I get less than nine hours,” she says, “I don’t feel well.” Bogdan recommends that you go to bed and get up at the same time every day. If you struggle to fall asleep at night, make sure you don’t look at a screen before bed. A study published in June 2020 in the journal Nature and Science of Sleep found that using a phone for at least 30 minutes before turning off the lights to go to bed was linked to poor sleep quality. The researchers suggest that the blue light emitted by electronic devices may suppress a person’s production of melatonin, a hormone that helps people feel tired.
2. Stay Active
Although exercise can boost your energy, going for a run or lifting weights can be challenging when you already feel exhausted. Bogdan tries to remedy this problem by going to the gym first thing in the morning, before a long workday tires her out. Exercising with other people can also be a good motivator, says Effie Siamalekas, 25, a videographer in Oakville, Ontario, Canada, who was diagnosed with ulcerative colitis in 2015. Although she’s been in remission since July 2016, she occasionally feels tired and tries to stay active by playing soccer, going to a driving range, or rock climbing with friends.
3. Eat a Healthy Diet
When you’re tired, you may be tempted to eat something sweet for an instant energy boost. But that’s a bad idea because that brief sugar high will inevitably turn into a sugar crash. Choose foods like eggs, peanut butter, bananas, and oatmeal (if you can tolerate fiber) instead, says Neilanjan Nandi, MD, a gastroenterologist and associate professor of clinical medicine at the University of Pennsylvania in Philadelphia. Staying hydrated is also important when you’re battling fatigue, says Emily Parris, 22, who was diagnosed with ulcerative colitis in 2013 and had her colon removed. “Drinking a lot of water is a challenge,” she says, “but it makes me feel much better.”
4. Open Up to Friends and Family
If you’re feeling too tired to go to a relative’s birthday party, for example, be honest about it. Parris says she hid her fatigue from family and friends for a long time because she was embarrassed. “But after I shared what I was going through, they were really supportive,” she says. “Plus, it made me stop looking like a flake when I couldn’t go out.”
5. Address Emotional Fatigue
Living with ulcerative colitis can be emotionally exhausting, especially during flares. Even when you’re in remission you can feel as if you’re “walking on eggshells,” Parris says, because you’re constantly worried about another flare. In addition, people with ulcerative colitis often feel alone. A review published in June 2021 in the journal Expert Review of Gastroenterology & Hepatology noted that people with inflammatory bowel disease (IBD) have higher rates of anxiety and depression than people who don’t. If you feel emotionally overwhelmed by your symptoms, ask your doctor for help. Some practices have psychologists who specialize in treating people with GI conditions.
6. Plan Your Day Carefully
If you’re experiencing an ulcerative colitis flare, you have only a limited amount of energy to spare. If you usually feel more energetic in the morning, plan to tackle your most demanding tasks at that time. Don’t overcommit when it comes to your social calendar. “Be realistic with yourself and know your limits,” says Parris. She suggests picking one or two events a week and planning for them. For example, if you have an upcoming dinner on a Saturday night, she says, spend that morning and afternoon relaxing instead of running errands.
7. Monitor Your Iron Levels
If you’ve experienced blood loss from an ulcerative colitis flare, your fatigue may be a sign of iron deficiency — a condition that is more likely to affect people who have IBD compared with people who don’t, according to a study published in 2021 in the American Journal of Managed Care. At the same time, the study suggests that anemia is often underdiagnosed and undertreated. Other symptoms of iron deficiency may include chest pain and pale or yellow skin. Your doctor can check your iron level with a blood test and treat any deficiency with oral supplements or iron infusions. Once you’ve replenished your iron stores, consider eating more iron-rich foods, like meat, fish, and cooked leafy green vegetables.
8. Give Yourself a Break
The fatigue you feel because of ulcerative colitis is much more severe than the tiredness a healthy person feels after a long day. Plus, it’s usually accompanied by other symptoms. “If I’m really tired,” says Bogdan, “I will also get nauseated.” Says Parris, “Going to the bathroom multiple times a day is tiring for anybody. It’s basically like having the stomach flu 24/7.” Bogdan recommends that you listen to your body and rest when you need to. “Don’t push yourself,” she says. If you sense a flare coming on, taking a break or a nap is a good idea, especially because it might help you feel better later. “Don’t feel that you have to keep up with everyone else,” Bogdan says. “You have a chronic illness that you have to manage.”
