Ulcerative Colitis Pain

Question: I have ulcerative colitis. What causes the abdominal pain associated with this disease?

Dr. Hibberd’s Answer:

Ulcerative colitis (UC) is an inflammatory disease of the colon. The degree of symptoms can vary, but the presence of pain is usually not a good finding.

This disorder causes inflammation of the colon absorptive surface, resulting in chronic diarrhea. When the inflammation becomes deeper, pain ensues, the colon dilates, and micro-abscesses often form. This impairs colon function, and the protective mucosal layer of bowel disturbed allows bacteria to escape into tissue.

If bacterial invasion occurs, the bowel forms abscesses, often dilates, and sometimes perforates. This colon rupture spills colon contents into the abdominal cavity resulting in dismal consequences for some despite aggressive intensive-care management.

People with untreated UC have a higher risk of developing colon malignancy and a preventive colectomy is advisable for those with persistent disease. Patients with UC should undergo regular surveillance colonoscopy and be supervised by a gastroenterologist or expert in diseases of the colon. Pain in patients with UC is a red flag for medical consultation without delay.