Pain is one of the key markers of Ulcerative Colitis. However, your pain location and severity often differ from person to person. Ulcerative Colitis (UC) pain originates from inflammation in the inner lining of the large intestine and can feel like stabbing pain or cramping in the abdominal area. However, some people with UC also experience pain in other areas of their body, such as their joints. Many people with UC, diagnosed or undiagnosed, assume the pain in their gut and their joints is unrelated, since UC is a GI condition. Let’s explore how they’re related.
Cause of Ulcerative Colitis Pain
Ulcerative Colitis is categorized as an autoimmune disease, which means that the body’s immune system attacks itself instead of protecting itself. In someone with UC, the immune system repeatedly sends white bloods cells to the intestinal lining to continue to attack what it views as a problem. This continued attack causes a buildup of inflammation in your intestinal lining. This inflammation can become so severe that it causes open sores (ulcers) to form in the innermost lining of the colon, large intestine or rectum. These sores can ooze mucus and pus, and cause pain in the area. Many people with UC also experience joint pain, a product of this inflammation spreading throughout the body. Increased pain is often a sign that inflammation is increasing and that your condition is becoming worse.
Ulcerative Colitis Pain Location
Each person perceives pain differently and thus describes their pain in different ways. We list common pain descriptors below:
- Painful Spasms
- “A Charley Horse in your gut”
UC pain location can also differ from person to person, depending on which part of their colon is most affected. The most common UC pain locations are listed below:
- Lower-abdominal pain
- This pain is typically associated with inflammation or ulcers in the colon.
- Often described as aching, cramping, spasmic pain.
- This pain occurs around the rectum and is often caused by irritation with passing bowel movements.
- Often described as burning, stabbing pain.
- This pain can occur in large or small joints and even the spine.
- This is often described as achiness and tightness in the joints.
- Back Pain
- Chronic lower back pain can be trigged by inflammation.
- This is often described as pain and stiffness in the lower spine, and may be accompanied with limited range of motion.
- Leg Pain
- This pain can manifest in your hips, knees, and ankles or as tender lumps on the legs.
- Often described as aches and pain in the joints or tenderness in certain spots on the legs.
- Neck Pain
- This pain occurs in the neck and surrounding areas.
The link between Ulcerative Colitis and joint pain is not exactly clear, but researchers believe that the immune system overreacts in response to UC, the inflammation becomes systemic and can spread to your joints. Although not all people with UC have joint pain, many find that as their GI symptoms worsen, so does the pain throughout their body. In these situations, it’s important to work with your doctor and dietitian to ensure this is a product of your UC and not a convergent health condition such as Rheumatoid Arthritis.
Triggers of Ulcerative Colitis Pain
While UC pain can be managed through diet, there are also many behaviors that can contribute to UC pain.
- Irregular eating habits
- Waiting too long to eat after waking up, skipping meals and eating too quickly are all irregular eating habits that can produce inflammation in your gut. People with UC tend to experience less pain when they eat smaller, more frequent meals because this allows their body to more effectively digest and pass food. It is also beneficial to eat slowly in a relaxed environment.
- Emotional stress
- The brain and gut are so interconnected that mental stress can trigger the pain receptors in your gut. Stress and GI conditions are a tricky duo because the stress gut connection is very cyclical in nature. Many times, stress causes symptoms and then increased symptoms cause more stress. Having an arsenal of stress-management techniques is crucial to managing any GI condition.
- Food triggers
- When UC symptoms are active, you may need to make temporary changes to the foods you’re eating. A Low-fiber, low residue meal plan is recommended to allow your gut to heal. Once you’ve reached a period of being symptom-free, you may slowly reintroduce high fiber foods as long as your symptoms do not return. Read more about how to treat a UC flare.
How To Relieve Ulcerative Colitis Pain
While there is no cure for UC, there are ways to relieve the pain and reduce the inflammation you feel. Dietary modifications are one strategy to help manage the pain. Shifting to a low fiber, low residue diet can help you find relief. Incorporate more low fiber fruits such as bananas, non-cruciferous vegetables such asparagus, cucumbers, and carrots, refined grain products like white bread and white rice, and lean protein sources like chicken, fish, and eggs. Additionally, try to avoid consuming refined sugar, alcohol, caffeine, high fat foods, high fiber foods, and spicy foods.
Beyond nutrition, there are other ways to control the pain you feel. Focusing on managing your stress level can help. Yoga, meditation, and breathing exercises are some activities you can try on your own. Joining a support group or speaking to a mental health professional may help as well. Talking to your doctor about different medications to help control pain is also important.
Although Ulcerative colitis is life-long, that doesn’t mean your UC pain has to be. When UC is well-managed, you can experience long periods of remission and become symptom-free. The key is to modify your approach based on the stage of your condition and learn to listen to your body. If you’re having trouble managing your UC, we recommend working with a dietitian who can help you obtain and sustain remission.
Kaitlyn Willwerth is a Registered Dietitian at OnPoint Nutrition. Kaitlyn's work focuses on providing individualized health and lifestyle coaching and, most importantly, support. She is a Certified LEAP Therapist and has also completed the Monash University 'Low FODMAP Diet for IBS' online training course for health professionals.