6 most common causes
Where is your colon?
Your colon, also known as the large intestine, is located in your abdomen. It’s about 5 to 6 feet long and travels up the right side of your abdomen, across the top, and down the left side. It absorbs water and nutrients and expels waste.
Segments of the colon include the cecum (which connects to the small intestine), the ascending colon, the transverse colon, the descending colon, and the sigmoid colon (which connects to the rectum).
What causes colon pain?
Pain in your colon may be caused by a temporary issue like an infection or a common condition like lactose intolerance.
In some cases, colon pain may be a sign of a serious illness, such as irritable bowel disease or diverticulitis. The pain can vary in location depending on what’s causing it.
Colon pain can be treated with medications like antibiotics and antispasmodic drugs, changes in your diet and, in some cases, surgery.
Colon pain is hard to pinpoint. Usually, you will have abdominal pain and symptoms that suggest your GI tract is the culprit. After that, discussions with your doctor, labwork, and imaging may pinpoint your colon as the culprit. —Dr. Shria Kumar
Many types of infections can affect your digestive system. They can change your bowel movements and cause colon pain and pain in other areas of your abdomen. The pain may occur when you have bowel movements or it may be unrelated to them.
Infections can be caused by viruses, bacteria, or parasites. Examples include:
- Food poisoning, which is caused by eating contaminated food or drinking contaminated water, or poor hand hygiene. Bacteria such as E. coli can cause food poisoning.
- Viruses such as norovirus (known for spreading on cruise ships), adenovirus (commonly spread among children in daycares), and COVID-19
- C. difficile infection, which can occur if you were recently hospitalized or are taking antibiotics
- Parasite infections, such as Giardia or Vibrio
Treatment includes staying hydrated and letting your bowel rest by eating bland foods. Some infections may clear up on their own. But if you have a bacterial or parasitic infection, you’ll need an antibiotic or anti-parasitic medication.
Always see your doctor if your symptoms are severe, they don’t improve after a few days, or you have a compromised immune system (from HIV, cancer, immunosuppressant medications, etc.). You may need to be hospitalized for monitoring and IV fluids.
2. Irritable bowel syndrome
- Colon pain
- More frequent stool (more than 3 times a day) or less frequent stool (less than 3 times a week)
Irritable bowel syndrome (IBS) is a common disorder of the gut that causes intestinal pain and changes in your bowel movements. There are three types of IBS: IBS-D (causes diarrhea), IBS-C (causes constipation), and IBS-M (causes alternating diarrhea and constipation).
Every type of IBS causes abdominal pain at least once a week. The pain usually occurs with bowel movements, and it may decrease afterwards.
It’s not known what causes IBS, but research suggests that communication to the brain and gut plays a role. It can affect you for months or years and significantly affect your quality of life. Flares of IBS can happen when you’re stressed, eat certain foods (often lactose-containing products), or are recovering from a stomach bug.
Your doctor will prescribe treatments based on your symptoms, such as antispasmodics for cramps and anti-diarrheal medication. Cognitive behavioral therapy may also be recommended to help reduce the effect of stress on your gut.
3. Inflammatory bowel disease
UC mostly affects the large intestine, while Crohn’s disease can occur anywhere in your gastrointestinal (GI) tract and even outside your intestines (particularly the skin and joints.) The pain can be in any part of your abdomen, depending on where the inflammation is located.
You should always see your doctor if you have symptoms of IBD. Left untreated, an inflamed colon can lead to serious problems, such as malnutrition, bleeding, certain cancers, and overall poor health.
The goal of treatment is to eliminate inflammation so the disease goes into remission. Your doctor will likely recommend changes to your diet and medication. Most people with IBD will have recurrence of symptoms (“flares”). If these are severe, surgery may be necessary to remove parts of the bowel.
4. Celiac disease
Celiac disease is an inflammation of your gut that’s triggered by eating foods that contain gluten, which is a protein in wheat, rye, and barley. When people with celiac disease eat gluten, their immune system attacks the small intestine, causing inflammation and pain.
This also causes damage to the lining of the small intestine, interfering with your ability to absorb vitamins and minerals and raising your risk of nutrient deficiencies.
Other complications of celiac disease include weight loss, tiredness, reduced bone density, severe skin rashes, mouth ulcers, and anemia.
Treating celiac disease
The treatment is to avoid eating gluten. Your doctor will also monitor your bone health to make sure you’re absorbing vitamin D.
The main things I’m listening for are accompanying symptoms. Is this truly GI-related, is it related to pelvic organs, or is it muscular? If it’s GI-related—what part of the GI tract? To answer this last question may require blood tests, lab work, and imaging. —Dr. Kumar
- Colon pain, usually in the lower left part of your abdomen
Diverticulitis is an inflammation of diverticula pouches, which form when areas of your intestines become weak. (Simply having these diverticula is called “diverticulosis.”) The pouches can develop in any part of the intestine but are most common in the lower part of your large intestine (the sigmoid colon).
Diverticulitis is more common in Western countries and may be triggered by lack of exercise and poor eating habits, such as eating a lot of processed food and too little fiber. These habits can lead to constipation, which puts pressure on the walls of the intestine and creates outpouchings.
If you have an infection (diverticulitis), your doctor will prescribe antibiotics. But this does not actually cure diverticulosis (the pouches), so it’s possible to develop more infections. In very severe cases, such as repeat infections, you may be referred to a surgeon to discuss removing parts of your intestine.
6. Lactose intolerance
- Colon pain after consuming lactose
Lactose intolerance is an inability to digest lactose, which is the main sugar in dairy products like milk, cheese, and ice cream. People with lactose intolerance don't make enough of an enzyme called lactase, which is necessary to digest lactose. Symptoms occur within 8 hours after you eat or drink dairy products.
Lactose intolerance is a relatively common problem that can be caused by genetics or older age. It may also develop after you have an intestinal infection. In this case, your lactose intolerance may go away once your gut bacteria return to normal.
Treating lactose intolerance
Lactose intolerance is treated by avoiding dairy products or taking a lactase supplement when you want to eat dairy.
Other possible causes
Several types of health problems may also cause colon pain, including:
When to call the doctor
Call your doctor if you have any of the following symptoms:
- Abdominal pain
- Bleeding with bowel movements
- Prolonged changes in bowel habits (more than 2 days, or not getting better after 2 days.)
- Nausea or vomiting
Important questions to ask your doctor are: What caused this? Should I change anything I am doing? Do I need any treatment? —Dr. Kumar
Should I go to the ER for colon pain?
You should go to the ER if you have:
- Lightheadedness, dizziness, feeling faint
- Severe abdominal pain
- Inability to eat or drink
- Eat a balanced diet.
- Drink plenty of water.
- Exercise regularly.
- Take lactase supplements.
- Ensure soft, daily bowel movements by drinking enough water, eating fruits and vegetables, and talking to your doctor about starting a laxative if needed.
Other treatment options
Treatment depends on the cause of the pain and may include:
- Antibiotics or antiparasitics
- Cognitive behavioral therapy
- Anti-diarrheal medications
- Avoiding dairy products
- Receiving IV fluids
- Treatments like chemotherapy and radiation therapy if you have cancer
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