Bowel Noises and Gastrointestinal Issues in AS Patients - Gastroenterology and Hepatology

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As a patient with ankylosing spondylitis (AS) experiencing bowel noises and gastrointestinal issues, it is understandable to feel concerned about your symptoms, especially given your recent medical history. Your symptoms of bowel noises, abdominal pain, and the presence of mucus in your stool can be distressing, and it’s important to address these concerns with a comprehensive understanding of your condition.

Firstly, the bowel noises (borborygmi) you are experiencing are often a normal part of gastrointestinal function, particularly after eating or when lying down. These sounds are produced by the movement of gas and fluids through the intestines. However, when accompanied by other symptoms such as abdominal pain or changes in stool consistency, they can indicate underlying gastrointestinal issues.

Your recent endoscopic findings revealed colonic ulcers and mild chronic inflammation, which could suggest a few potential conditions, including inflammatory bowel disease (IBD) such as ulcerative colitis or Crohn's disease, although your biopsy results did not show malignancy. The presence of ulcers in the sigmoid colon and the mild chronic inflammation noted in the pathology report are significant and warrant further investigation, especially given your ongoing symptoms.

The fact that you have lost weight and are experiencing abdominal pain, albeit less frequently, raises additional concerns. Weight loss can be a sign of malabsorption or chronic inflammation, which can occur in conditions like Crohn's disease. While you mentioned that you have been improving your diet and exercise habits, it is crucial to ensure that these changes are not masking a more serious underlying condition.

Regarding your question about whether to proceed with a CT scan or small bowel endoscopy, it is essential to weigh the potential benefits against your concerns. A CT scan can provide a more comprehensive view of your abdominal organs and help identify any structural abnormalities, while a small bowel endoscopy can directly visualize the small intestine and assess for conditions like Crohn's disease or other inflammatory processes.

Given your history of gastrointestinal symptoms and the findings from your recent procedures, it may be prudent to consider further evaluation. If you are apprehensive about the procedures, discussing your fears with your healthcare provider can help. They can provide reassurance, explain the necessity of these tests, and help you understand how they can contribute to a more accurate diagnosis and effective treatment plan.

In the meantime, continue to monitor your symptoms closely. Keep a diary of your bowel habits, dietary intake, and any associated symptoms such as pain or discomfort. This information can be invaluable for your healthcare provider in determining the next steps in your care.

Lastly, it may also be beneficial to consider a referral to a gastroenterologist if you have not already done so. They specialize in gastrointestinal disorders and can provide targeted management for your symptoms, including dietary recommendations, medications, and further diagnostic testing as needed.

In summary, while your bowel noises and gastrointestinal symptoms can be concerning, they are not uncommon in patients with AS and other gastrointestinal conditions. Given your recent findings and ongoing symptoms, further evaluation through imaging or endoscopy may be warranted to rule out any serious underlying conditions. Open communication with your healthcare provider about your concerns and symptoms will be key in managing your health effectively.