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Advice re upcoming colonoscopy

I have ankylosing spondylitis, I’ve had it for over 30yrs, 23 of them undiagnosed. Last Sunday, I had stomach cramps at 1am, and passed lots of maroon coloured stool, as well as a lot of blood. Hubby was asleep, so I checked BP etc, and went back to bed, hoping it was a one off. Unfortunately at 8:30 the same happened, again about 10 secs of blood gushing out after passing the Marion stool. 111 sent me to A&E, who referred me to the surgical emergency unit. I had bloods done which showed a lactate of 3.5, as well as deranged electrolytes. They gave me a litre of plasmalyte. The Dr was extremely busy, didn’t ask about history meds etc, and made his mind up its haemarroids. He has organised an urgent colonoscopy which is on the 28th. I’m being admitted the day before for prep as I have severe adrenal insufficiency and diarrhoea can result in a life threatening crisis. After 3 days the maroon stools have subsided and stools are normal, I’m using fybogel which they advised. I’m still getting cramps after eating foods I’m normally fine with, and have to rush to the loo. I know 10% of AS patients have IBD, and 60% have subclinical symptoms. I’m just wondering if 3.5 weeks on and the blood loss has resolved, will the colonoscopy still show IBD. I’ve been told my drop in haemoglobin shows I lost approx 500mls. My BP has been low since, my pulse in the 90s just sitting, feeling fatigued all the time, I should add I had foot surgery a month ago, and have been off my methotrexate and biologic for 6-7 weeks, so wondering if being off the meds has unmasked IBD. Thank you if you’ve taken the time to read this,

  1. Hi . Your concern is certainly understandable. You are correct that IBD and ankylosing spondylitis can go together. In fact, we have a sister-site for that condition and here is an article on the connection with IBD: Concerning the colonoscopy, be sure that a biopsy is done to help confirm if it is IBD. The diagnostic process can be pretty complex and this article from our editorial team gives an overview: Also, being off of your medication could increase fatigue and other symptoms and potentially IBD, but a doctor would have to do the proper diagnostics for IBD. Hope this information is helpful and that you get some answers and relief soon. Best, Richard (Team Member)

    1. many thanks for your response. Since stopping my immunosuppressants I have noticed the night sweats returning, along with the endless fatigue. I also noticed I’m suddenly getting bloated in the evening, after eating meals I’ve tolerated for years. I was diagnosed with Lactose intolerance at the same time as the AS. If they take biopsies which indicate IBD is there other tests that need to be undertaken, or should the biopsy provide answers. My blood tests did confirm the blood loss, as well as raised white cells despite being at the end of a course of antibiotics, and feels it is more likely raised due to inflammation, as I feel well in myself, and wound infection has cleared. Thanks for all the info, much appreciated 👍

    2. Hi , I do hope that your doctor can give you some answers. Unfortunately, we can not say for certain whether your doctor will want to do other tests if the biopsies indicate IBD. Oftentimes IBD is diagnosed using "pairs of tests" instead of just one, but again, I can't say for sure how your doctor diagnoses IBD. I will link an article here with some information on different tests and procedures,, and this article talks a bit about whether IBD can be missed with tests/procedures, Sorry I couldn't be more specific! Please, if you're comfortable, keep us posted! -- Warmly, Christine (Team Member)

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