I like Lialda because it is once daily, and because ti covers the left colon better.
But, common causes of fatigue are anemia (from bleeding), and possibly toxicity from leaky gut. Possibly shoulder and joint pain could just be inflammation, a kind of extra-colonic consequence of autoimmune disease.
I would have iron and hemoglobin levels checked, and possibly really up the probiotic dosage. If you are anemic, you will feel a lot better once back into the normal range. Porbiotics can help reduce the permeability of the mucosal lining and underlying epithelial layer.
Be careful with oral iron supplements however, because they can cause gas, cramps, and diarrhea (or even constipation and other IBS symptoms). You need to find a form you tolerate well and/or get an iron infusion - if you are very anemic.
That said, there is some weariness that accompanies all the bother of UC, and restful sleep can be disturbed. You will need to investigate and judge these possibilities for yourself.
Post Edited (DBwithUC) : 6/25/2012 8:37:37 AM (GMT-6)