In severe cases, doctors may recommend surgery. This can involve removing all or part of the large intestine and creating alternative paths for waste to leave the body.
This article explores ways to alleviate or manage UC-related pain.
Medications play a key role in the management of pain related to UC and other forms of inflammatory bowel disease (IBD). Your doctor will carefully assess the severity of your condition before recommending a suitable medication.
Some IBD medications are available over-the-counter (OTC), while others are prescription-based.
The Crohn’s and Colitis Foundation lists some common IBD pain medications as follows:
- antidepressants
- antispasmodics
- steroids
- opioids
Antidepressants mainly treat anxiety and depression, but they may also help manage pain. They have anti-inflammatory properties and may therefore reduce symptoms related to inflammation, but more research is needed.
Examples include:
- selective serotonin reuptake inhibitors (SSRIs)
- serotonin noradrenaline reuptake inhibitors (SNRIs)
- tricyclic antidepressants
Antispasmodics are a class of medications that relax the smooth muscles of the intestinal walls. They can suppress involuntary muscle contractions in the intestines and relieve UC-related pain. Examples include hyoscyamine (Levsin) and dicyclomine (Bentyl).
Steroids or glucocorticoids work by inhibiting excessive immune activity and inflammation. This may improve pain related to UC and other forms of IBD for short periods. Examples of steroids include prednisone (Deltasone) and budesonide (Entocort).
Opioids are a class of medications that interact with pain-causing nerve cells. They can provide temporary relief from UC-related pain. However, they can also carry severe risks, such as the potential for misuse.
Examples of opioids available legally by prescription include hydrocodone (Vicodin) and oxycodone (OxyContin).
Nonsteroidal anti-inflammatory drugs
Though some doctors may recommend nonsteroidal anti-inflammatory drugs (NSAIDs) for UC pain, others advise against it. NSAIDs may contribute to IBD flare-ups in some people. Speak with your doctor about NSAID safety in UC before using them.
Learn more about ulcerative colitis medications.
Using complementary therapies in conjunction with regular UC pain treatments may contribute to pain relief. Research from 2018 lists these potential complementary therapies for UC pain and other related symptoms:
- mind-body therapies
- probiotics
- exercise
- Chinese herbal medicine
- acupuncture and moxibustion
These techniques may take your mind off the pain you experience temporarily. They may also reduce stress, which is a known risk factor for IBD flare-ups.
Examples of mind-body therapies include meditation and yoga.
Probiotics are live microorganisms that may have some health and digestive benefits. Research suggests that probiotics are anti-inflammatory and may therefore benefit UC symptoms such as pain and diarrhea. However, more studies are needed.
Research from 2021 found that while physical activity wasn’t associated with a decrease in UC disease activity, many people reported beneficial effects.
Keep in mind that IBD can lower your tolerance for physical activity. Talk with your doctor about levels of physical activity that may be safe for you.
A 2022 research review noted that some evidence exists to support the idea that Chinese herbal medicine may relieve UC symptoms, including pain. These formulations may be made of single herbs or a combination of 2 or more herbs.
Examples include Huang Lian and Bai-Tou-Weng-Tang. More research is necessary to determine how Chinese herbal medicine may fit into a UC treatment regimen.
Acupuncture and moxibustion
Acupuncture is a technique in which practitioners insert needles into the skin to stimulate specific sensory nerves. Moxibustion is a traditional Chinese therapy that involves burning a special herb on or near the surface of the skin.
Practitioners of moxibustion may perform the technique in conjunction with acupuncture.
In a 2020 case report, a 60-year-old person assigned male at birth with UC received moxibustion. The person’s symptoms, which included abdominal pain and diarrhea, improved significantly after the therapy. More rigorous clinical trials are needed to further evaluate moxibustion’s potential benefits.
Another 2020 review of several studies concluded that, while additional studies are necessary, acupuncture could be effective as a stand-alone or combination therapy for UC.
Learn 9 ways to improve quality of life with ulcerative colitis.
Some foods can contribute to inflammation and pain, while others can reduce it. A 2018 review suggests some foods to avoid and others to eat with UC as follows.
Foods to avoid can include:
- fat-based foods, such as margarine and some cooking oils
- animal protein, such as red meat and processed meat
- excess sugar
Foods to eat can include:
- fish containing omega-3 fatty acids, such as salmon and mackerel
- insoluble fiber foods, such as bran and cellulose
- curcumin
Talk with your doctor before making changes to your diet.
Learn more about the best and worst foods for ulcerative colitis.
Doctors may consider colectomy for persistent UC pain, which is surgery to remove all or part of the large intestine. Your surgeon may perform it in one of the following ways:
- Ileostomy: This involves removing the entire large intestine and forming an opening in the abdominal wall for waste to pass.
- Ileoanal pouch: This involves forming a pouch with the small intestine and attaching it to the anus. This technique allows a person to pass waste through the anus.
Colectomy may reduce UC pain and other symptoms, but it may also raise the risk of infection and other complications. Your doctor will work to reduce the risks associated with surgery.
Learn more about ulcerative colitis surgery.
Pain commonly occurs with ulcerative colitis (UC). Treatments include antidepressants, steroids, and antispasmodics. Other management methods include mind-body exercises, acupuncture, and surgery.
Follow your doctor’s treatment plan as closely as possible if you have UC.