Abdominal pain is one of the most common problems for people with ulcerative colitis (UC). Your treatment plan should give you long-term relief, but you may still experience the occasional bout of stomach cramps and pain.
“An inflamed colon is unable to process and absorb water efficiently,” says Roopa Vemulapalli, MD, a gastroenterologist and associate professor in the division of digestive and liver diseases at the University of Texas Southwestern Medical Center in Dallas. “It also can go into frequent spasms.” This can happen even when the colon is not inflamed.
If you’re experiencing stomach cramps with your UC, use these tips to alleviate the pain.
1. Add Acetaminophen
For people with UC, not all over-the-counter pain medications are created equal. Unlike acetaminophen (Tylenol), narcotics and nonsteroidal anti-inflammatory drugs, or NSAIDs, can actually worsen your symptoms, says Amar Naik, MD, a gastroenterologist and director of the inflammatory bowel disease (IBD) program at Midwest Digestive Health and Nutrition in Des Plaines, Illinois. You should also talk to your doctor about the underlying cause of your stomach cramps, he says. In general, though, acetaminophen is considered safe for use in UC and is not associated with flares.
2. Avoid Your Personal Trigger Foods
If your cramps tend to flare after a meal, your body is probably struggling to digest something you ate. Trigger foods can worsen inflammation and gas, which increase stomach pain, Dr. Naik says. Keeping a food log can help you spot any culprits, which may include lactose, fried foods, or caffeinated drinks. You may also want to consider talking to a registered dietitian nutritionist, who can help you pinpoint your triggers and find a meal plan that works for you.
3. Take a Gas-Relieving Product
Available over-the-counter, these remedies, such as simethicone (Gas-X), break up the gas bubbles in your digestive tract, helping to reduce gas, says Dr. Vemulapalli, although they may not be effective for everyone. You can also ask your doctor whether an antispasmodic medication, such as dicyclomine (Bentyl) or hyoscyamine (Levbid), may relieve your stomach cramps, she says.
4. Use a Warm Water Bottle
Heat helps relieve muscle pain, which can be caused by straining your bowels on the toilet, Naik says. To ease cramps, try holding a warm water bottle against your belly; just make sure it’s not hot enough to burn or scald your skin. You can also wrap it in a towel until it cools off.
5. Try Yoga
Practicing yoga can be another way to ease UC stomach cramps and abdominal pain. One study found that people with IBD who added one hour of daily yoga to their treatment plan felt less abdominal pain after eight weeks than people who didn’t do yoga.
Another study concluded that people with UC who did weekly 90-minute sessions of yoga for 12 weeks reported having less disease activity — and fewer flare-ups — than those who tried other techniques, such as reading self-care books.
6. Be on the Lookout for Signs of Depression and Anxiety
People who have IBD, including UC, have a higher risk of anxiety and depression compared with those who don’t have IBD. Research has found that up to a third of people living with IBD are affected by anxiety symptoms and a quarter experience depression. The prevalence is even higher in those with active disease. The relationship is cyclical – depression and anxiety might make your abdominal pain worse.
Physical symptoms like muscle tension, shortness of breath, and heart palpitations
Difficulty controlling worried feelings
Sleep problems and fatigue
If you think you may have depression or anxiety, talk to your doctor, who may refer you to a psychologist or psychiatrist.
7. Stick to Your Treatment Plan
Make sure you’re taking your medication exactly as prescribed, Vemulapalli says. If your symptoms, such as stomach pain or cramps, are frequently flaring up despite your drug regimen, though, call your doctor. They might have you try a new treatment for your UC or prescribe a different dosage.
“A well-healed colon is a happy colon,” Vemulapalli says.
The Takeaway
Abdominal pain and stomach cramps are extremely common symptoms of ulcerative colitis (UC) that can affect quality of life, but there are ways to find relief.
Taking over-the-counter medicines like acetaminophen and simethicone, avoiding trigger foods, and practicing yoga to relieve stress are effective ways to reduce UC stomach cramps.
Talk to your doctor if you experience frequent stomach pain or cramping despite following your treatment plan.
EDITORIAL SOURCES
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Resources
Ulcerative Colitis. Mayo Clinic. November 22, 2024.
Sharma P et al. Effect of Yoga-Based Intervention in Patients With Inflammatory Bowel Disease. International Journal of Yoga Therapy. January 1, 2015.
Koch AK et al. Perceived Stress Mediates the Effect of Yoga on Quality of Life and Disease Activity in Ulcerative Colitis. Secondary Analysis of a Randomized Controlled Trial. Journal of Psychosomatic Research. March 2020.
Hu S et al. Depression and Anxiety Disorders in Patients With Inflammatory Bowel Disease. Frontiers in Psychiatry. October 8, 2021.
Barberio B et al. Prevalence of Symptoms of Anxiety and Depression in Patients With Inflammatory Bowel Disease: A Systematic Review and Meta-Analysis. The Lancet Gastroenterology & Hepatology. May 2021.
Yuying Luo, MD, is an assistant professor of medicine at Mount Sinai West and Morningside in New York City. She aims to deliver evidence-based, patient-centered, and holistic care for her patients.
Her clinical and research focus includes patients with disorders of gut-brain interaction such as irritable bowel syndrome and functional dyspepsia; patients with lower gastrointestinal motility (constipation) disorders and defecatory and anorectal disorders (such as dyssynergic defecation); and women’s gastrointestinal health.
She graduated from Harvard with a bachelor's degree in molecular and cellular biology and received her MD from the NYU Grossman School of Medicine. She completed her residency in internal medicine at the Icahn School of Medicine at Mount Sinai, where she was also chief resident. She completed her gastroenterology fellowship at Mount Sinai Hospital and was also chief fellow.
Madeline Vann, MPH, LPC, is a freelance health and medical writer located in Williamsburg, Virginia. She has been writing for over 15 years and can present complicated health topics at any reading level. Her writing has appeared in HealthDay, the Huffington Post, Costco Connection, the New Orleans Times-Picayune, the Huntsville Times, and numerous academic publications.
She received her bachelor's degree from Trinity University, and has a master of public health degree from Tulane University. Her areas of interest include diet, fitness, chronic and infectious diseases, oral health, biotechnology, cancer, positive psychology, caregiving, end-of-life issues, and the intersection between environmental health and individual health.
Outside of writing, Vann is a licensed professional counselor and specializes in treating military and first responders coping with grief, loss, trauma, and addiction/recovery. She is a trauma specialist at the Farley Center, where she provides workshops on trauma, grief, and distress tolerance coping skills. She regularly practices yoga, loves to cook, and can’t decide between a Mediterranean style diet and an Asian-fusion approach.
