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

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Ankylosing Spondylitis (AS) is a type of inflammatory arthritis that primarily affects the spine and can lead to severe, chronic pain and discomfort. It is characterized by inflammation of the vertebrae, which can result in chronic pain and stiffness in the back. However, the connection between AS and gastrointestinal symptoms, such as stomach pain, can be complex and multifaceted.

Firstly, it is important to note that while AS primarily affects the spine and sacroiliac joints, it can also have extra-articular manifestations, including gastrointestinal issues. Some studies have suggested that individuals with AS may have a higher prevalence of inflammatory bowel diseases (IBD), such as Crohn's disease and ulcerative colitis. These conditions can cause abdominal pain, diarrhea, and other gastrointestinal symptoms. However, the direct correlation between AS and stomach pain is not universally accepted, and many healthcare professionals may argue that the two conditions are separate.

In your case, you mentioned experiencing stomach pain and vomiting, sometimes to the point of expelling bile. This could indicate a gastrointestinal issue that may or may not be related to your AS. The fact that you have undergone endoscopy and colonoscopy without any findings suggests that there may not be an obvious structural problem in your gastrointestinal tract. However, functional gastrointestinal disorders, such as irritable bowel syndrome (IBS), could still be a possibility. IBS can cause abdominal pain and discomfort, often triggered by stress, diet, or changes in routine, which may coincide with your AS flare-ups.

The relationship between your back pain and stomach pain could also be influenced by the medications you are taking. You mentioned using Celebrex (celecoxib), a non-steroidal anti-inflammatory drug (NSAID), which can sometimes cause gastrointestinal side effects, including stomach pain and nausea. If you find that your stomach pain worsens with the use of NSAIDs, it may be worth discussing alternative pain management strategies with your healthcare provider.

Regarding your symptoms of stiffness and pain, it is not uncommon for individuals with AS to experience variations in their symptoms. Some may have morning stiffness, while others may not. The fact that your symptoms seem to be triggered by weather changes or prolonged sitting is also consistent with AS, as many patients report that their symptoms can be exacerbated by certain activities or environmental factors.

As for 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 individuals find that taking medication regularly helps to manage their symptoms more effectively and prevents flare-ups, while others prefer to take medication only as needed. It is essential to have an open discussion with your rheumatologist or healthcare provider about your treatment plan, as they can provide personalized recommendations based on your specific situation.

In conclusion, while there may be a connection between Ankylosing Spondylitis and gastrointestinal symptoms, it is essential to consider other potential causes of your stomach pain. A comprehensive evaluation by a healthcare professional, including a review of your medications and any additional gastrointestinal assessments, may provide further insights into your symptoms. It is crucial to work closely with your healthcare team to develop a management plan that addresses both your AS and any gastrointestinal concerns you may have.