How to Manage Pain With Ulcerative Colitis
If you have pain and aren’t sure how to treat it, talk to your provider first. They may recommend acetaminophen (Tylenol) or other options before trying NSAIDs.
NSAID Alternatives
“For more severe pain, there are several prescription medications we can consider that are safer for the gut than NSAIDs,” says Mayer. Some options, he says, include:
- Antispasmodics for cramping
- Antidepressants for chronic pain
- Gabapentin and pregabalin for nerve-related pain
Your provider may prescribe opioid pain medications for severe short-term pain or injury, says Mayer. “[But] they are generally avoided for long-term use due to the risk of dependence and other side effects.”
Lifestyle Changes for Pain Management
“Beyond medication, lifestyle modifications can also play a significant role in pain management,” says Mayer. He recommends these habits to help decrease chronic pain with UC:
- Dietary changes: Identify and avoid trigger foods to help manage symptoms.
- Stress management: Techniques like yoga, meditation, and regular exercise can help reduce stress, a known IBD trigger. This in turn may reduce IBD flares.
Precautions While Taking NSAIDs
“If your inflammatory bowel disease is in deep remission, a short course of NSAIDs may be okay if needed,” says Ali.
For his patients taking NSAIDs, Ali watches for any GI-related side effects, like:
- More frequent diarrhea
- Rectal bleeding
- Stomach pain
Ali also recommends these precautions while taking NSAIDs with UC:
- Use the lowest dose that works.
- Keep the treatment as short as possible.
- Try to avoid taking NSAIDs every day for a long time.
- Work closely with your gastroenterologist, especially if your UC has been active recently.
“Do not ignore ongoing pain,” says Ali. “If you have pain that does not go away, talk to your gastroenterologist instead of treating yourself with NSAIDs over and over.”
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