Does ulcerative colitis cause pain on the left side of the abdomen?

Does Ulcerative Colitis Cause Pain on the Left Side of the Abdomen?

Yes, ulcerative colitis can cause pain on the left side of the abdomen, and this is one of the more common ways the condition presents. However, not everyone with ulcerative colitis experiences pain in the same location or with the same intensity. Understanding why left-sided pain happens, what it feels like, and when it matters can help you make informed decisions without unnecessary worry.

This article explains the connection in clear, practical terms and is based on established medical understanding from gastroenterology research and clinical guidelines.

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What Is Ulcerative Colitis?

Ulcerative colitis is a long-term inflammatory condition that affects the lining of the large intestine (colon) and rectum. It belongs to a group of conditions called inflammatory bowel disease (IBD).

Key features of ulcerative colitis include:

• Ongoing inflammation of the colon
• Small sores (ulcers) in the bowel lining
• Periods of flare-ups and periods of remission
• Symptoms that can range from mild to severe

Importantly, ulcerative colitis always starts in the rectum and can extend upward through the colon. This pattern helps explain why pain often appears on the left side.

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Why Ulcerative Colitis Causes Left-Sided Abdominal Pain

The left side of your abdomen contains the descending colon and sigmoid colon, which are common areas affected by ulcerative colitis.

Left-sided pain happens because:

• Inflammation irritates the bowel wall, making it sensitive and sore
• Muscle spasms occur as the colon tries to move stool through inflamed areas
• Ulcers can cause a burning or aching sensation
• Gas and stool movement through narrowed or inflamed sections can increase discomfort

When ulcerative colitis is limited to the rectum and left colon (often called left-sided colitis or proctosigmoiditis), pain is most likely to be felt on the lower left side of the abdomen.

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What Does the Pain Usually Feel Like?

Pain linked to ulcerative colitis varies from person to person, but it is often described as:

• Cramping or squeezing
• A dull, persistent ache
• Pressure or fullness
• Pain that improves after a bowel movement

The discomfort may:

• Come and go throughout the day
• Worsen before needing to use the bathroom
• Increase during a flare-up
• Improve during remission

For many people, the pain is uncomfortable but manageable. For others, it can interfere with daily activities, especially when inflammation is active.

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Other Common Symptoms That May Occur With Left-Sided Pain

Left-sided abdominal pain rarely appears on its own in ulcerative colitis. It is often accompanied by other bowel-related symptoms, including:

• Frequent diarrhea
• Blood or mucus in the stool
• An urgent need to use the bathroom
• Feeling like the bowel is not fully empty
• Fatigue
• Mild to moderate weight loss during flares

Some people also experience symptoms outside the gut, such as joint pain or skin irritation, though these are less common.

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When Left-Sided Pain Might Not Be Ulcerative Colitis

While left-sided abdominal pain is common in ulcerative colitis, it is not unique to it. Other conditions can cause similar pain, such as:

• Irritable bowel syndrome (IBS)
• Diverticular disease
• Constipation
• Gastrointestinal infections
• Gynecological conditions (in people with ovaries)
• Kidney or urinary tract issues

This is why ongoing or unexplained pain should not be self-diagnosed. Context matters—especially the presence of inflammation, bleeding, or persistent bowel changes.

If you're experiencing left-sided abdominal pain along with other digestive symptoms, Ubie's free AI-powered Ulcerative Colitis symptom checker can help you understand whether your symptoms align with this condition and guide your next steps.

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Can Ulcerative Colitis Cause Severe Left-Sided Pain?

It can, particularly during a flare. Severe pain may occur when:

• Inflammation is extensive
• Ulcers are deep
• The colon becomes significantly swollen
• Bowel movements are very frequent

That said, severe or sudden pain is not something to ignore. While most pain in ulcerative colitis is not life-threatening, intense or worsening pain—especially if combined with fever, heavy bleeding, or dehydration—requires medical attention.

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How Doctors Evaluate Left-Sided Abdominal Pain

To determine whether ulcerative colitis is the cause of left-sided pain, doctors may use:

• A detailed symptom history
• Blood tests to check for inflammation or anemia
• Stool tests to rule out infection
• Colonoscopy or sigmoidoscopy to directly view the colon
• Biopsies of the colon lining

These steps help confirm the diagnosis and rule out other conditions that can mimic ulcerative colitis.

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Managing Left-Sided Pain From Ulcerative Colitis

Pain management focuses on treating the underlying inflammation, not just masking discomfort.

Common treatment approaches include:

• Anti-inflammatory medications that target the colon
• Immune-modulating therapies for moderate to severe disease
• Rectal treatments (suppositories or enemas) for left-sided disease
• Dietary adjustments during flares
• Stress management, which can help reduce symptom intensity

Many people find that when inflammation is controlled, pain improves significantly or disappears altogether.

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Living With Ulcerative Colitis and Abdominal Pain

Ulcerative colitis is a long-term condition, but many people live full, active lives with proper care. Pain on the left side of the abdomen does not necessarily mean the disease is worsening—it often reflects active inflammation that can be treated.

Helpful self-care strategies may include:

• Keeping track of symptoms and triggers
• Following prescribed treatment plans
• Staying hydrated
• Eating in a way that supports digestion during flares
• Seeking support when symptoms affect daily life

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When to Speak to a Doctor

You should speak to a doctor if you experience:

• Persistent or worsening left-sided abdominal pain
• Blood in your stool
• Unexplained weight loss
• Fever or signs of infection
• Pain that interferes with daily activities
• Any symptom that feels severe, sudden, or concerning

Some complications of ulcerative colitis can be serious if left untreated, so timely medical advice is important.

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Key Takeaway

Ulcerative colitis commonly causes pain on the left side of the abdomen, especially when inflammation affects the descending or sigmoid colon. The pain is usually cramp-like and linked to bowel movements, and it often improves when inflammation is properly treated.

If you are experiencing symptoms and want a starting point, consider using Ubie's free AI-powered Ulcerative Colitis symptom checker to better understand your symptoms and determine whether it's time to seek medical care.

Most importantly, speak to a doctor about any symptoms that are persistent, worsening, or potentially serious. Early evaluation and treatment can make a meaningful difference in comfort, safety, and long-term health.