Digestive Health Inflammatory Bowel Disease Living With What Inflammatory Bowel Disease Pain Feels Like By Amber J. Tresca facebook twitter linkedin Amber J. Tresca is a freelance writer and speaker who covers digestive conditions, including IBD. She was diagnosed with ulcerative colitis at age 16. Learn about our editorial process Amber J. Tresca Medically reviewed by Medically reviewed by Jay N. Yepuri, MD, MS on September 22, 2020 facebook twitter linkedin Jay Yepuri, MD, MS, is board-certified in gastroenterology. He is a partner with Digestive Health Associates of Texas and a medical director at Texas Health Harris Methodist HEB Hospital. Learn about our Medical Review Board Jay N. Yepuri, MD, MS on September 22, 2020 Print Table of Contents View All Table of Contents Right or Middle Upper Middle Variable Pain Rectal Pain Left-Sided Pain Severe Pain Pain and Diagnosis Symptoms of inflammatory bowel disease (IBD) can include diarrhea, blood in the stool, weight loss, and abdominal pain. The type and location of abdominal pain is different, not only between the two main forms of IBD (Crohn's disease and ulcerative colitis) but also within the subtypes of these diseases. Further, pain is even more individual to each person, to the point where people with the same subtype of Crohn's disease or ulcerative colitis may experience pain in a different way. In fact, some people with IBD don't have any abdominal pain at all during IBD flare-ups. In addition, abdominal pain can be related to other issues (either unrelated or extra-intestinal manifestations), such as appendicitis, gallstones, or gastroesophageal reflux disease (GERD). But as abdominal pain is a common symptom of IBD, here is an overview of the types of abdominal pain that are most often experienced by people with IBD. Abdominal Quadrants Understanding and communicating where pain is located can be helpful when working with physicians, since different sections of the abdomen contain different organs. The abdomen is typically thought of as having four sections: Right upper quadrant Right lower quadrant Left upper quadrant Left lower quadrant The imaginary lines between the upper and lower quadrants and the right and left quadrants intersect at the navel. "Right" and "left" are the patient's right and left (not the physician's). Right or Middle Abdomen Pain A pain that feels like cramps in the middle of the abdomen or the lower right quadrant is typical of the types of Crohn's disease known as ileocolitis and ileitis. Ileocolitis is the most common form of Crohn's disease and is defined by inflammation located in the last section of the small intestine (the ileum) and in the large intestine (colon). Ileitis is a type of Crohn's disease that affects only the ileum and is the second most common form. People with ileitis may also find that their pain or discomfort appears within a few hours of eating a meal. Upper Middle Abdomen Pain A type of Crohn's disease known as gastroduodenal Crohn's disease often causes pain located in the middle and upper sections of the abdomen. Gastroduodenal Crohn's disease affects the stomach and the duodenum (the first section of the small intestine). This type of Crohn's disease is far less common than ileocolitis and ileitis. Variable Abdominal Pain With jejunoileitis, abdominal pain varies greatly and can be characterized as either mild or severe. This type of Crohn's disease affects the jejunum (the middle section of the small intestine) and is a fairly uncommon subtype. People with jejunoileitis may also experience crampy pain after eating. Rectal Pain Pain that is located in the rectum (the structure located at the end of the large intestine) is a symptom of ulcerative proctitis. Ulcerative proctitis is a type of ulcerative colitis and is how about one-third of ulcerative colitis cases begin. Left-Sided Pain Pain on the left side of the abdomen is one of the more classic symptoms of ulcerative colitis. Two types of ulcerative colitis that can cause left-sided pain are proctosigmoiditis and distal or left-sided colitis. In proctosigmoiditis, ulceration is located in the rectum and the sigmoid colon (the last section of the large intestine). In left-sided colitis, the rectum, sigmoid colon, and the descending colon are affected by inflammation. Left-sided colitis pain can be severe at times. Signs of an IBD Flare Severe Abdominal Pain Severe pain in the abdomen can be a symptom of many different digestive conditions, but as it relates to IBD pain, it can be associated with pancolitis. Pancolitis is the type of ulcerative colitis that is characterized by ulceration throughout the entire large intestine. Red Flag Symptoms Any pain that is new to you, is severe, or is happening at the same time as symptoms such as lack of stool, abdominal bloating, nausea, constipation, or vomiting is cause for a call to your doctor or a trip to the emergency room. These symptoms could be due to a more serious condition, such as toxic megacolon or a bowel obstruction. Pain as a Tool for Diagnosis Because pain can come from different sources, and pain in the abdomen is particularly difficult to pinpoint, it is not a symptom that is normally used to diagnose IBD or a particular form of IBD. Rather, the type and location of pain is more often used together with other signs and symptoms when diagnosing IBD or other conditions. In other words, it might be a starting point to help a physician know where to start looking for inflammation, but it's only one part of the picture. A Word From Verywell With IBD, some pain is considered a symptom, but certain types of pain should be considered a red flag and be discussed with your physician as soon as possible. People with IBD tend to take a lot of pain in stride and not complain about it, but pain is always something that should be discussed at gastroenterologist visits. What You Should Eat During an IBD Flare-up Was this page helpful? Thanks for your feedback! We're providing tips on how to take better care of your gut. Sign Up You're in! Thank you, {{form.email}}, for signing up. There was an error. Please try again. What are your concerns? Other Inaccurate Hard to Understand Submit Article Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Crohn's & Colitis Foundation. Overview of Crohn's disease. Crohn's & Colitis Foundation. Types of ulcerative colitis. Johns Hopkins Medicine. Crohn's disease.