Not sure if IBD

41yrs old male, no chronic illnesses. Gallbladder and appendix were removed about 14 years ago when this first started and both came out with little to no signs of acute inflammation. I've also suffer from hemorrhoids for the past 21 years. Its maybe importante to note that my mom has the same symptoms but milder and less frequent.

My symptoms come in episodes that i'll try to describe as best as i can.

First phase lasts about 24 hrs and starts with my gut becoming less and less active (almost like aura symptoms that help me predict when is coming) accompanied by epigastric discomfort , gas comes out less frequently and in less quantity. I get really bloated and theres a generalized pain not too intense but very uncomfortable. Then comes what feels like fever but never reaches temperatures above 100.4, body aches, arthralgia and shivering are present at the end of this phase.

Then comes a phase that also lasts about 24-36 hrs where i'm relieved by the former symptoms but is replaced by an intense sharp localized pain in the right hypochondrium. Movement or vibrations makes it worse, can't think of breathing any deeper than a normal breath or to laugh, cough etc because it makes it even worse. (funny thing the hypocondrium pain reflects on my right shoulder almost as intense and it also gets worse with movements) This sharp pain has also presented in the left side and travels to the left shoulder.

Got a colonoscopy/biopsy (3 of them to this day) where they found diverticula up to the sigmoid section but nothing else.

This episodes seem to come in cycles, there's periods of time where I get it every week (which have driven me to depression) , others where it comes every month or 2. There’s been times when a presentation has followed the previous one without any days in between them which have caused mild suicidal thoughts while symptomatic. Diet doesn't seem to make any difference.

Lab tests have never showed anything relevant enough to help the diagnosis but have found ultra sensitive PCR of 64 (during a presentation), Vitamin D deficiency and HLAb27 negative. CAT scan with mild non localized inflammation during or at the end of one of the presentations.

Ive learned to live with this. At first I used a lot of sick days, but now i just do my best to function while going through episodes. Paracetamol combined with metamizole or a strong dose of metamizole alone helps with the body aches and shivering in the first phase. 30mg of sublingual ketorolac for the abdominal pain in any of the phases is what works the best.

My mom has the same symptoms but milder and less frequent.

Mesalazine 1gr every 8 hrs has been helpful to stop episodes if i take it very early in the presentation when i notice a difference in bowel activity, and even helped me to live without symptoms for as long as 6 months, but symptoms came back after i stopped taking it.