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Medically reviewed and verified by Kate Burke, MD, MHA
Ulcerative colitis (UC) is a chronic inflammatory bowel disease that primarily affects the large intestine and rectum. One of the most common symptoms people with UC experience is abdominal pain. This usually happens in the lower left side of the abdomen. Has this happened to you? Are you wondering why so many people with this condition tend to experience pain in the same area? Look no further. PatientsLikeMe has a breakdown of the symptom.
Why Does Ulcerative Colitis Cause Pain?
Ulcerative colitis often starts between the ages of 15 and 30 or between 50 and 70. The exact cause of UC is still not fully understood! We do know that factors such as genetics, immune system dysfunction, and environmental triggers like smoking and diet play a role. UC is an autoimmune condition, meaning the body's immune system mistakenly attacks healthy tissue. In UC, this leads to inflammation and ulcers in the lining of the colon and rectum. These ulcers can cause bleeding, mucus discharge, and pain.
Pain in ulcerative colitis is primarily because of inflammation. When the lining of the colon becomes inflamed, it can lead to cramping and discomfort. The location of the pain often depends on which part of the colon is affected.
- Left-sided colitis: This is when inflammation starts in the rectum and extends through the colon's left side. This leads to pain on the lower left side of the abdomen.
- Proctosigmoiditis: Proctosigmoiditis on the other hand affects the rectum and the sigmoid colon (the lower part of the colon). It leads to similar pain in the left lower abdomen.
The pain can range from mild to severe, depending on the level of inflammation. During a flare-up, when symptoms get worse, pain can get particularly intense. The often feels like cramping and can be accompanied by an urgent need to pass stool, diarrhea, and blood in the stool.
Inflammation and Pain
Inflammation is the driver of pain in UC. When the colon is inflamed, chemicals are released that irritate the nerves in the gut. This inflammation can also lead to scar tissue, known as strictures, which can add to discomfort and pain by narrowing the colon. This makes making it harder for stool to pass through. Even when the inflammation dies down, some people with UC continue to experience pain. Often this is because the nerves in the gut have become hypersensitive, a condition known as visceral hypersensitivity. Even normal movements of the intestines or mild inflammation can cause serious pain.
Pain Beyond the Abdomen
While abdominal pain is the most common symptom, UC can also cause pain in other parts of the body.
- Rectal pain: Especially common in those with proctitis, a type of UC that primarily affects the rectum.
- Lower back and hip pain: This happens when inflammation spreads to the joints and spine.
- Joint pain: UC can lead to arthritis, causing pain in the knees, ankles, and other joints.
- Skin and mouth pain: Ulcers and sores can develop, leading to discomfort in these areas.
Managing Pain in Ulcerative Colitis
Managing pain in UC involves treating the underlying inflammation and addressing the pain directly. The most common approach is through medications. Aminosalicylates are anti-inflammatory drugs specifically designed to treat IBD. They help reduce inflammation in the colon and are often the first line of treatment for UC. Corticosteroids are powerful anti-inflammatory drugs used for short-term relief during flare-ups. They are not good for long-term use because of their side effects. Immunosuppressants like azathioprine and methotrexate suppress the immune system to prevent it from attacking the colon. Biologics are newer drugs that target specific parts of the immune system. They are often used when other treatments haven't worked. Pain relievers like acetaminophen are generally considered safe for UC. Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen should be avoided, however, as they can trigger flare-ups.
Lifestyle and diet changes can also help! A low-residue diet is when you limit high-fiber foods that are harder to digest. This can reduce irritation in the colon. Certain foods, such as dairy, spicy food, and caffeine have been found to trigger symptoms. Managing stress and exercising regularly are also good ways to reduce pain. It’s important to get medical help if you feel persistent or severe abdominal pain. This is especially true if it is accompanied by symptoms like blood in the stool, severe diarrhea, or weight loss.
Pain is a common and challenging symptom of ulcerative colitis! Rest assured, you are not alone when it comes to feeling pain or irritation in the lower left side of your abdomen. You can find relief from this symptom. Through a combination of medication and lifestyle adjustments, many people are able to get on top of their pain! Be sure to stop by PatientsLikeMe for more information and support.