Ulcerative colitis is a chronic, unpredictable condition that affects all people differently. Some people can go years without symptoms, while others struggle with frequent flares and terrible pain.

But people with ulcerative colitis can take some control over their abdominal pain and other symptoms. Taking medication, eating healthy, exercising regularly, getting enough sleep, and dealing with stress and depression can all help reduce the chances that a flare will occur, says Sunanda V. Kane, MD, a gastroenterologist at the Mayo Clinic in Rochester, Minn.

Defining Ulcerative Colitis Pain

The first step in managing abdominal pain from ulcerative colitis involves you and your doctor tracking down exactly what’s wrong. "Treatment of pain is best when the cause is found and addressed," Dr. Kane says.

To help your doctor figure out what’s causing your abdominal pain and other symptoms, you need to be able to accurately describe your pain. Before seeing your doctor, take stock of what you're feeling. Be ready to describe:

  • How long you've had your pain
  • Where you feel your pain
  • How it feels, both in sensation and intensity
  • If your pain is constant or comes and goes
  • How often you feel pain
  • What things seem to trigger your abdominal pain

"The more specific you can be about your pain, the better," Kane says. Is your pain crampy and intermittent? Is it typically associated with a bowel movement, or is it all the time? Is it related to food? Is it in the abdomen or the rectal area? What makes it better and what makes it worse? Is it associated with nausea and vomiting?

Also be prepared to talk with your doctor about any negative emotions you might feel due to your condition — especially if you’ve been feeling depressed. People who are severely depressed have been shown to feel pain more acutely. They also have elevated levels of proteins called cytokines, which send signals to the immune system and can increase pain by promoting inflammation. Ulcerative colitis is an inflammatory condition of the colon, so increased inflammation caused by depression can intensify your pain and other symptoms.

How to Manage Ulcerative Colitis Pain

Once you’ve described your pain accurately, your doctor will likely be able to track the cause of your pain and begin treating it. Methods of pain management that have been shown to help people with ulcerative colitis include:

Medication. Sticking to your prescribed medication regimen is the best way to control ulcerative colitis. There are a number of different drugs your doctor can prescribe to treat your specific symptoms. Some modify your immune system to better control ulcerative colitis, while others decrease inflammation in your gut. If you skip doses or don't take the medication as prescribed, you will reduce its effectiveness and risk having a flare.

Diet and nutrition. While food doesn’t specifically cause ulcerative colitis, your diet can affect your symptoms. You may need to adopt a diet that’s low in salt, fiber, or fat, or is free of lactose or gluten. Ask your doctor if caffeine or carbonated beverages might worsen your symptoms, or if you should eat bland foods and avoid spicy dishes. Finally, you might need to take a vitamin supplement if ulcerative colitis interferes with your body's ability to absorb nutrients.

Stress management. Stress functions much like depression in exacerbating the pain and other symptoms of ulcerative colitis. Learning ways of managing stress through methods like meditation, yoga, tai chi, and deep breathing may help relieve stress and lessen the effect your emotional state has on your ulcerative colitis pain. You might also consider joining a support group, where you can find helpful advice and comfort in talking with others with ulcerative colitis. Finally, people with consistent stress might consider seeing a mental health professional to learn coping strategies.

Alternative therapies. Some people with ulcerative colitis find that complementary and alternative therapies can help lessen the frequency and intensity of their pain and other symptoms when used in conjunction with their conventional therapy. These can include hypnosis, biofeedback, massage therapy, acupuncture, acupressure, and supplements like fish oil capsules or aloe vera. "Alternative therapies like yoga, massage therapy, acupuncture, and hypnotherapy have been shown to help," Kane says. Discuss any alternative medicines with your doctor before proceeding so you'll know the pros and cons.

Considering surgery. Surgery can be considered the ultimate long-term treatment for ulcerative colitis. Between 25 and 33 percent of people with ulcerative colitis may require surgery at some point, either to deal with complications or to have part or all of their colon removed. Ulcerative colitis can be considered "cured" once the colon is removed, but other problems related to the immune system such as joint pain, skin conditions, and digestive problems are still possible.