Lifestyle and Social Risk Factors of Pain


Smoking increases the risk of developing Crohn’s disease and makes the disease worse. This increases the need for steroids, immunosuppressants, and surgeries.

Back to top


Anxiety or distress about about (pain-related anxiety) has been associated with the use of harmful substances like alcohol. The use of alcohol to cope with pain tends to increase over time. Drinking alcohol at levels higher than what is considered safe leads to tolerance. Also, withdrawal causes pain sensitivity, leading to more drinking.

New research in animals has raised concerns with alcohol use in IBD, where alcohol was found to increase weight loss, inflammation of the colon, and risk for infection in ulcerative colitis.

Back to top


Although IBD has been historically associated with underweight and malnutrition, rates of obesity have been rising in patients with IBD. Obesity is associated with worse disease in patients with IBD.

Back to top

Family issues and relationships

Your pain experience can be influenced by how your partner or family responds to your pain. In general, people with less social support are more likely to experience pain and depression.

Back to top

Employment status

Pain can be influenced by demands at work and how your employer or coworkers respond to your pain. Also, if you are not able to work because of your illness, you may be more likely to experience pain.

IBD patients tend to have higher absenteeism (inability to attend work), presenteeism (reduced ability to complete assigned tasks while at work), and productivity loss (absenteeism and presenteeism). 

Back to top

Ethnic background

The prevalence of chronic pain is similar between developed (37%) and developing (41%) countries. However, pain is often undertreated in ethnic minority groups, which can lead to more chronic pain.

Back to top

Socioeconomic background

People from a lower socioeconomic status consistently experience higher rates of chronic pain and more severe pain. People from higher socioeconomic backgrounds report better access to pain management.

Back to top

Gender and sex

Women tend to experience a higher level of pain. They tend to feel more intense pain and have a different sensitivity to analgesics than men. Women seek treatment for pain more often than men. There is some evidence to suggest these differences are due to hormones. Menstruation may increase pain in some people.

Back to top

Other factors

Certain foods, physical activity, or weather changes may increase pain in some people.

Back to top

In This Section

Back to IBD Journey