Ulcerative colitis (UC) causes inflammation in your colon and small intestine, which can be painful. Other debilitating or uncomfortable symptoms can include diarrhea, nausea, and fatigue. And UC symptoms aren’t necessarily physical in nature: a study published in November 2016 in the journal Gastroenterology found that “In patients with IBD, the most common psychosocial and modifiable conditions are chronic abdominal pain, anxiety, and depression.”

Just as the causes of ulcerative colitis pain are diverse and highly individual to each person, the treatments are also varied, and must be tailored to your individual needs. These treatments can include medication, psychological therapy, relaxation techniques, physical activity, or a combination of the above. The important thing is to be attuned to your pain and to communicate with your doctor to be sure that you’re managing it in the best possible way.

How to Describe Ulcerative Colitis Pain

It can be hard to explain to your doctor the type of pain you feel because pain is personal and subjective. By keeping a written record of your pain in a colitis symptom journal you will be able to quantify your experience for your doctor. Record the following information:

  • When the pain began and when it ended
  • Where you felt the pain
  • What you were doing when you noticed the pain, or in the hours before
  • How severe the pain was on a scale of 1 to 10

Use descriptive words when discussing the pain, such as dull, achy, cramping, throbbing, or piercing. Bring your notes to your doctor's appointment. This information will help your doctor understand what’s going on inside your body. Figuring out the cause of the pain is the first step to effectively eliminating it.

Finding the Right Medication to Treat Your Pain

Medications work to control and reduce the inflammation, thereby reducing pain associated with ulcerative colitis.

The most important thing is to treat the source of the pain, says Faten Aberra, MD, co-director of the Inflammatory Bowel Disease Center at the Hospital of the University of Pennsylvania and the Children’s Hospital of Pennsylvania. If inflammation is increasing, that can be a sign to change medications. Antispasmodic medications, which are used to treat spasms in the gut, are helpful as well, but narcotics are generally avoided. “If basic treatment isn’t successful then you may need the help of an anesthesiologist who specializes in pain management,” Dr. Aberra adds.

The bottom line is that if your medication isn’t working properly, the solution might be to try a different type. The trial-and-error process can be frustrating at times, as there’s no way to predict which drug will work best for you. But the sooner you get started, the sooner you may find relief.

Alternative Pain Treatments for Ulcerative Colitis

Diet and stress may also contribute to the pain you are feeling. Here are some lifestyle modifications and alternative pain remedies that have been proven effective in people with ulcerative colitis.

  • Diet and nutrition: Some people with ulcerative colitis notice flare-ups after eating certain foods. Keeping a food journal can help you figure out which foods cause pain, and which you can better tolerate. Avoiding foods high in fiber may also help, according to Gary Lichtenstein, MD, director of the Inflammatory Bowel Disease Center at the Hospital of the University of Pennsylvania. “If the disease goes into a state of remission and the abdominal pain persists, then it’s important to search for other concurrent disease states, such as celiac sprue, lactose intolerance, and so on,” he said. Eating multiple smaller meals throughout the day can also help manage digestive pain.
  • Relaxation and stress management: Stress can cause ulcerative colitis flare-ups, and there is increasing evidence that interactions between your brain and your gut are altered with ulcerative colitis. Exercise, meditation, and other relaxation techniques that reduce the effects of stress may also help control the pain associated with these flare-ups. Some helpful relaxation therapies include progressive muscle relaxation, psychotherapy, and other types of complementary alternative medicine. For example, a study published in 2015 in the International Journal of Yoga Therapy found that an eight-week yoga program helped ulcerative colitis patients with intestinal pain, as well as anxiety levels.

Getting the Support You Need to Manage Pain

In addition to working with your doctor to find a physical solution for your pain, it might be worthwhile to seek professional and peer support, as well.

Pain and depression, anxiety, and stress often go hand-in-hand. Your doctor can put you in touch with mental health professionals who have experience working with people with ulcerative colitis. In therapy, you can learn new ways to think about pain, plus other coping strategies.

In addition, consider joining an ulcerative colitis support group. Group members may have practical tips for managing pain, or they may simply offer comfort by reminding you that you are not alone in your struggle.

If you're suffering from ulcerative colitis pain, the most important thing to do is to tell your doctor. With the information from your colitis symptom journal, your doctor may be better able to accurately identify the triggers for your pain and get you feeling better sooner.