The good news: There are steps you can take to manage the cramping and minimize this painful symptom of UC. Here are some of the most common questions you might have about abdominal pain and cramping, including how you can find relief.
1. What is UC cramping?
Abdominal pain and cramping from UC is most commonly caused by the condition’s inflammatory process, according to Christina Ha, MD, a gastroenterologist at Cedars-Sinai Medical Center in Los Angeles. Such inflammation usually starts at the rectum and moves throughout the large colon. The greater the inflammation, the more severe the pain. Doctors diagnose UC based on where symptoms are occurring. Many people with the condition experience what’s known as left-sided colitis, where the pain and inflammation occur on their left side, from the rectum up to the descending colon. Cramps can also be accompanied by bloating and gas, which cause a feeling of pressure and knotting in your abdomen.
3. What causes UC cramping?
Common causes of UC cramping, according to Ha, are flare-ups, lack of sufficient control of the condition (even with medication), eating foods that are high in saturated fat or sugar, and adverse reactions to medication. Cramping due to gas and bloating can also be caused by irritable bowel syndrome (IBS), a separate condition from ulcerative colitis that can cause symptoms even when your disease is in remission. IBS can be linked to certain gas-causing foods, including dairy if you’re lactose intolerant.
4. How common is cramping among those who have UC?
Inflammatory bowel disease, which includes both UC and Crohn’s, affects about 1.6 million Americans of all ages, according to the Crohn’s and Colitis Foundation. More than half of those with UC experience abdominal pain. The frequency and persistence of cramping can help determine the severity of UC, according to Faten N. Aberra, MD, MSCE, co-director of the Inflammatory Bowel Disease Center at the Joint Penn-CHOP Center and an associate professor of medicine at the Hospital of the University of Pennsylvania, in Philadelphia. Pain that comes and goes with bowel movements may indicate a moderate level of UC. Constant cramping and frequent, bloody stools, on the other hand, may indicate a more serious condition, says Dr. Aberra, such as a dilated colon.
5. When does cramping usually happen?
UC cramps can be exacerbated by food, so many people notice cramping after eating or before a bowel movement, says Ha. Cramping can also be tied to eating trigger foods, which often include high-fiber fruits and veggies, lactose, nonabsorbable sugars, high-fat or sugary foods, alcohol, and caffeine. The hormone fluctuations that occur during a woman’s menstrual cycle may also trigger UC cramping, according to a study published in January 2018 in Inflammatory Bowel Diseases. Cramping can occur at all times and throughout the night. Medication and other treatments can help reduce symptoms.
6. When should you call your doctor?
If you’re experiencing certain symptoms, chances are, your current treatment is not working and it’s time to consider a change in therapy, says Ha. Call your doctor if:
Cramping is severeYou’re experiencing a significant amount of abdominal pain that requires medicationYou have a fever that lasts longer than a couple of daysYou experience nausea or vomitingYou have ongoing diarrhea or blood in your stool
7. What’s a good plan to manage UC cramping?
By working on your treatment with your healthcare provider, you can lessen the pain from UC cramping, according to Aberra. Follow these recommendations. Monitor your medications. Talk to your doctor about any prescription, over-the-counter, or herbal medications you’re taking. Iron deficiency is common with UC, but oral iron supplements have been shown to increase the risk of inflammation and cramping. Some antibiotics and pain relievers, such as ibuprofen, may also increase flare-ups and cramping. Review your diet. Keep a food diary and note the connection between the foods you eat and your UC symptoms. In general, it’s smart to stay away from processed foods and those high in saturated fat and sugar. High-fiber foods and dairy products can also cause UC cramping, but check with your doctor before eliminating foods from your diet, to ensure you’re getting the nutrients you need. Eat frequent, small meals. Instead of two or three large meals, eat four to six smaller meals spaced more closely throughout the day. Also, take your time while eating and chew thoroughly. Skip caffeine and carbonated drinks. Caffeine can cause gas, intensifying abdominal cramping. It is also a stimulant, which can make cramping and diarrhea worse. Drink enough water. People with UC may be at increased risk of dehydration, so be sure to drink plenty of H2O. A good rule of thumb, according to the Crohn’s and Colitis Foundation, is to aim for about 64 ounces (oz) — or eight 8 oz glasses — per day.
