When it comes to back pain, it can be easy to overlook the affect the gut has on the back. For people with inflammatory bowel disease, there may be a substantial link between the two. It is worth noting that in the U.S., 60 to 70 million people suffer from digestive diseases. That’s approximately 18-22% of the American population, or 1 in 5 people. Furthermore, for many of these people, the symptoms associated with inflammatory bowel disease extend beyond the abdomen. As a result, an inflamed gut can both cause and/or exacerbate back pain.
INFLAMMATORY BOWEL DISEASE
Inflammatory bowel disease is an overarching medical term that describes conditions involving inflammation in the digestive system. The digestive system includes the stomach, large intestine and small intestine. It is sometimes referred to as the ‘gut.’ Inflammatory bowel disease can affect different parts of the gut depending on the individual. However, the two most common subtypes of inflammatory bowel disease are Crohn’s disease and ulcerative colitis. Both of these conditions are autoimmune diseases. An autoimmune disease is a disease where the body’s immune system turns on the body. So the normally beneficial antibodies that the immune system produces begin to attack good tissues. As a result, chronic inflammation develops in the body. This inflammation can lead to further health complications if left untreated.
Crohn’s disease is an inflammatory bowel disease that affects the lining of the digestive tract. It most commonly shows up in the last part of the small intestine and in the colon. The inflammation caused by Crohn’s disease causes the bowel wall to swell. This swelling leads to a narrowing and/ or scarring of the digestive tract. The result is an obstructed passageway that makes it difficult for waste to pass through the gut. Sometimes the inflammation caused by Crohn’s disease can tunnel into the bowel wall. This is called a fistula. While there is no cure for Crohn’s disease, diet and lifestyle choices make managing the disease easier. In some cases, the disease may go into remission.
Ulcerative colitis is an inflammatory bowel disease that primarily affects the colon. The colon is also known as the large intestine. This condition is characterized by inflammation and open sores or ulcers. These ulcers produce pus, mucous and, at times, blood. Due to the aggravation of the large intestine, people feel abdominal pain and/or cramping. Furthermore, there can be an increase in the frequency of bowel movements. There are different types of ulcerative colitis that are classified depending on the location of the ulcers and how severe the symptoms are. The different types are ulcerative proctitis, proctosigmoiditis, left-sided colitis, Pancolitis, and acute severe ulcerative colitis.
INFLAMMATORY BOWEL DISEASE AND BACK PAIN
The severity of an individual’s inflammatory bowel disease will affect someone’s back pain proportionately. It is more typical for people with Crohn’s disease to experience extra-intestinal manifestations than people with ulcerative colitis. Regardless, back pain that occurs as a result of these inflammatory bowel diseases is more often than not felt in the low back. This low back pain is usually brought on by a swelling of the joints. This inflammation in the joints limits mobility and causes pain and/or discomfort in the back. Notably, the joints of the spine and the sacroiliac joints experience the most swelling.
Back pain caused by inflammatory bowel disease cannot be resolved through external treatments. And while researchers do not believe that diet causes inflammatory bowel disease, food can affect it. Therefore it is important to avoid foods that cause inflammation. Most of all, avoid dairy, spicy food, caffeine, alcohol and refined sugars. Fiber should also be limited as it may make the symptoms associated with inflammatory bowel disease worse. Furthermore, smoking also aggravates Crohn’s disease. While there is not enough data to support the correlation between stress and inflammatory bowel disease, anecdotal evidence suggests there could be a link. Individuals with inflammatory bowel disease report having more severe flare-ups in stressful periods of time.
In conclusion, back pain and inflammatory bowel disease are directly related. The inflammation found in the digestive tract causes inflammation to occur in the spine and sacroiliac joints. Finally, this back pain can be managed through healthy lifestyle choices and proper medical attention.
Evans, Paul E. and Darrell S. Pardi. “Extraintestinal Manifestations of Inflammatory Bowel Disease: Focus on the Musculoskeletal, Dermatologic, and Ocular Manifestations.” MedGenMed 9, no. 1 (March 19, 2007). Accessed December 20, 2016. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1925026/.
“Health Statistics.” July 22, 2016. Accessed December 20, 2016. https://www.niddk.nih.gov/health-information/health-statistics/Pages/digestive-diseases-statistics-for-the-united-states.aspx#1.
Mayo Clinic. “Crohn’s Disease Definition.” August 14, 2014. Accessed December 20, 2016. http://www.mayoclinic.org/diseases-conditions/crohns-disease/basics/definition/con-20032061.
Mayo Clinic. “Inflammatory Bowel Disease (IBD) Lifestyle and Home Remedies.” February 18, 2015. Accessed December 20, 2016. http://www.mayoclinic.org/diseases-conditions/inflammatory-bowel-disease/basics/lifestyle-home-remedies/con-20034908.