It important to determine if your pain is originating in your abdomen (intra-abdominal) or outside your abdomen (extra-abdominal).
Pain occurring inside the abdomen is typically caused by disease activity (inflammation of your gastrointestinal tract). If you are experiencing abdominal pain, your healthcare provider may run some tests to find out if your disease is active.
Extra-abdominal can include ocular pain (pain in your eyes), musculoskeletal pain (pain in your muscles and/or joints), or dermatological pain (pain related to conditions affecting your skin).
For more cause of pain inside or outside abdomen, visit our next page on Sources of Pain.
Inflammatory vs non-inflammatory pain
It is also important for healthcare providers to identify if your pain is due to inflammation or not, in order to make the right decisions in their approach to pain management.
Inflammatory pain in your abdomen is generally due to active disease or flare up on your IBD. Inflammation is a process by which your body's white blood cells protect you from infection. Inflammation due to IBD can be determined by healthcare providers using a combination of tests and procedures.
Inflammatory pain elsewhere in your body could be caused by complications of your IBD. For example, joint pain could be caused by inflammation associated with arthritis, which can be shown on certain blood tests.
Non-inflammatory pain is not caused by inflammation. It can occur independent of disease activity. Examples of non-inflammatory pain may include a blockage in your intestines, adhesions (scar tissue) arising from surgery, or joint pain not associated with arthritis.
Functional pain is another example of non-inflammatory pain associated with bowel movements including diarrhea and constipation. It is sometimes referred to as, irritable bowel syndrome (IBS)-like pain.
Inflammatory and non-inflammatory types of pain can occur at the same time.
Visceral vs somatic pain
Visceral pain is pain originating from the internal organs (chest, abdomen, or pelvis). Visceral pain is vague and not localized and can be caused by inflammation of the lining of your intestinal tract.
Somatic pain is easier to pinpoint and is typically localized to your skin, muscles, bones, or joints.
Acute vs chronic pain
Acute pain is defined as pain lasting less than three months. In general, a flare-up of inflammation from IBD is a harmful stimulus that causes acute pain in the abdomen. Other causes of acute pain associated with IBD may include fistulas and abscess, bowel obstruction, and fissures.
Chronic pain persists after the flare-up has resolved, and is defined as pain lasting longer than three months. The cause of chronic pain in IBD is complex and can be influenced by a combincation of physical, psychological, and social factors.