Can Ankylosing Spondylitis Cause Stomach Pain? Exploring the Connection - Internal Medicine

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Ankylosing Spondylitis (AS) is a type of inflammatory arthritis that primarily affects the spine and the sacroiliac joints in the pelvis. It can lead to chronic pain and stiffness in the back and neck. However, many patients with AS also report gastrointestinal symptoms, including stomach pain, nausea, and even vomiting. This connection can be complex and multifaceted.

Firstly, it is important to understand that AS is associated with systemic inflammation. This means that the inflammatory processes that affect the spine can also impact other organs, including the gastrointestinal tract. In some cases, patients with AS may develop inflammatory bowel disease (IBD), which includes conditions like Crohn's disease and ulcerative colitis. These conditions can cause abdominal pain, diarrhea, and other gastrointestinal symptoms. While you mentioned that you have undergone endoscopy and colonoscopy without any findings, it is still possible for gastrointestinal symptoms to arise from the inflammatory processes associated with AS.

Moreover, the pain you experience in your stomach could also be related to the medications you are taking. For instance, non-steroidal anti-inflammatory drugs (NSAIDs), which are commonly used to manage pain in AS, can irritate the stomach lining and lead to gastritis or ulcers, causing abdominal pain and nausea. If you are taking medications like Celecoxib (as you mentioned "希樂葆"), it is crucial to monitor for any gastrointestinal side effects. If you notice a correlation between your medication and stomach pain, it would be wise to discuss this with your healthcare provider.

Additionally, the symptoms you describe, such as vomiting bile, could indicate a more serious gastrointestinal issue, such as a blockage or severe gastritis. Even if previous tests have shown no abnormalities, if your symptoms persist or worsen, further evaluation may be warranted. It might be beneficial to consult a gastroenterologist who can provide a more specialized assessment of your gastrointestinal symptoms.

Regarding your question about whether to take medication continuously or only when in pain, this is a common dilemma for many patients with chronic conditions. Some patients find that taking medication regularly helps to manage their symptoms more effectively and prevents flare-ups, while others prefer to take medication only when they experience significant pain. This decision often depends on the severity of your symptoms, the side effects of the medication, and your overall treatment plan. It is essential to have an open discussion with your rheumatologist about your treatment strategy, as they can help tailor a plan that addresses both your AS and any gastrointestinal concerns.

Lastly, while you may not experience morning stiffness, which is a hallmark symptom of AS, it is important to remember that the disease can manifest differently in each individual. The variability in symptoms does not negate your diagnosis. If you feel that your symptoms are not aligning with typical AS presentations, it is worth discussing this with your rheumatologist. They may consider adjusting your treatment plan or exploring other potential diagnoses that could explain your symptoms.

In conclusion, while there may not be a direct correlation between Ankylosing Spondylitis and stomach pain for every patient, the inflammatory nature of AS can indeed lead to gastrointestinal symptoms. It is crucial to monitor your symptoms closely, communicate with your healthcare providers, and consider both your rheumatological and gastrointestinal health in your treatment plan.