What Questions Should I Ask My Doctor
If you have ankylosing spondylitis, you may want to ask your healthcare provider:
- Why did I get ankylosing spondylitis?
- What is the best treatment for ankylosing spondylitis?
- What are the treatment risks and side effects?
- What lifestyle changes should I make to manage the condition?
- Is my family at risk for developing ankylosing spondylitis? If so, should we get genetic tests?
- Am I at risk for other types of arthritis or back problems?
- What type of ongoing care do I need?
- Should I look out for signs of complications?
A note from Cleveland Clinic
Ankylosing spondylitis is a form of arthritis that mostly affects the spine. Its a lifelong condition without a cure. However, exercise, medications and lifestyle changes can help manage symptoms so you can enjoy a long, productive life. Its rare for someone with AS to become severely disabled. Talk to your healthcare provider about the steps you can take to stay active and manage symptoms.
Last reviewed by a Cleveland Clinic medical professional on 07/21/2020.
What Are The Most Common Crohns Disease Symptoms
Crohns disease can manifest in different ways depending on the severity of your condition and where the inflammation has taken hold, so not everyone has the exact same experience. Ahead, read about the most common Crohns symptoms, according to the NIDDK and Mayo Clinic.
Were talking persistent, unexpected, and urgent diarrhea that doesnt respond well to over-the-counter medications. Though the timeline varies, diarrhea can last anywhere from a few days to a few months during Crohns disease flare-ups, Ashkan Farhadi, M.D., gastroenterologist at MemorialCare Orange Coast Medical Center and director of MemorialCare Medical Groups Digestive Disease Project in Fountain Valley, California.
Diarrhea happens because of the gut inflammation inherent to Crohns, Dr. Farhadi says. Even though Crohns can impact any part of your digestive system, it typically affects the last part of the small intestine and the colon , according to the Mayo Clinic. It makes perfect, painful sense that when these parts of your digestive tract are irritated, they cant do their jobs properlyand you can get some pretty severe diarrhea as a result. Whats more, Crohns-induced inflammation can also cause the affected parts of your digestive tract to become hyperactive and spasm too much, which can force food to move through your system far too quickly, resulting in those really loose, watery stools.
What Questions Should I Ask My Healthcare Provider
You may want to ask your healthcare provider:
- What type of IBD do I have?
- Whats the best treatment for me?
- What foods or drinks should I avoid?
- What lifestyle changes should I make?
- Am I at risk for other problems?
- Should I look out for signs of complications?
A note from Cleveland Clinic
Most people with inflammatory bowel disease enjoy active lives. Still, symptoms of Crohns disease and ulcerative colitis can be life-disrupting. Some people go into remission after taking medications. Some people need surgery to deal with severe symptom flare-ups. Your healthcare provider can suggest dietary and lifestyle changes to manage IBD.
Last reviewed by a Cleveland Clinic medical professional on 05/03/2021.
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What Other Steps Can I Take To Manage Or Treat Ankylosing Spondylitis
In addition to standard AS treatments, these steps may also help ease inflammation and pain:
- Eat a nutritious diet: Fried foods, processed meats and foods high in fat and sugar can have an inflammatory effect. Anti-inflammatory diets, such as the Mediterranean diet, may help fight inflammation.
- Maintain a healthy weight: Obesity and excess weight puts pressure on joints and bones.
- Limit alcohol consumption: Drinking too much alcohol can weaken bones and increase the risk of osteoporosis.
- Stop smoking: Tobacco use accelerates spinal damage and intensifies pain. Your provider can help you quit smoking.
Axial Spondyloarthritis And Crohns Disease
In a small 2012 study, researchers found that spondyloarthritis affected roughly 19 percent of participants with Crohns disease. Spondyloarthritis tends to appear in certain people more often than others. People in their teens and 20s, particularly males, are affected most often. Those who have family members with spondyloarthritis are also at an increased risk of developing the condition, according to the American College of Rheumatology.
The main symptoms of axSpA are stiffness and pain in the lower back, hips, and buttocks lasting for three or more months. Flare-ups typically come on slowly, gradually worsening over several weeks or months. Symptoms tend to be at their worst in the morning and wear off with time and exercise. Prolonged rest or inactivity can make joint pain worse.
I cant bend or twist like I used to, wrote one MyCrohnsAndColitisTeam member. It hurts too bad. Being up and about helps, but getting up for those first few steps after sitting awhile is so painful, and I cant fully stand upright sometimes for a minute or so. Its frustrating.
These symptoms result from enthesitis inflammation of the entheses, areas where ligaments and tendons enter the bone. This can cause enthesopathy .
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How Do You Get A Crohns Disease Diagnosis
Any time you have blood in your stool, thats not normal, Dr. Higgins says. Thats a red flag on its own and should prompt a call to your doctor. Otherwise, having a random bout of abdominal pain and diarrhea that goes on for two or three days might be just a fluke, but if it persists for longer than that or you experience multiple bouts of a few days of symptoms at a time, see your doctor, Dr. Higgins says. Additionally, having an unexplained fever lasting more than two days and sudden weight loss are also reasons to make an appointment.
Diagnosing Crohns disease is a detailed process that often requires a few steps involving tests and potential procedures. At your first appointment, youll have a physical exam so your doctor can check for stomach bloating, tenderness, and signs of Crohns disease pain. Its worth preparing a list of your Crohn’s disease symptoms and how often they happen, in addition to thinking about your personal and family medical history, since your doctor should discuss those with you as well.
If necessary, your doctor may recommend doing lab tests , imaging , or procedures like a colonoscopy , to help look for signs of Crohns disease. However, its important to note that there is no single test to identify Crohns disease or other forms of IBD, so you may need to undergo several of these before your doctor lands on a final diagnosis.
Kidney Infections And Kidney Stones
Kidneys are the bean-shaped organs located in the posterior half of the body toward the middle of the back that filter waste products from the body, regulate bodily fluids, and perform other important functions. Its very easy for , says Dr. Crooks.
Wheres the pain?
What are the other possible symptoms? Fever, nausea, and malaise, burning sensation when you urinate
What does the pain feel like? Pain may feel higher and deeper in the back vs. lower back pain. You can also have side and groin pain. Note, the pain typically doesnt go away when you shift positions, lie down or rest.
Kidney stones and kidney infections can cause back pain.
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Do Different Types Of Crohns Disease Cause Different Symptoms
Heres where things get a bit more complex. There are different types of Crohns disease, and theyre categorized by which part of your GI tract the condition is targeting. Although there are commonalities among all forms of Crohns disease, you may be prone to certain symptoms depending on the type you have, says Dr. Higgins.
According to the Cleveland Clinic, the types of Crohns disease include:
How Can Crohns Disease Lead To Arthritis
Your genes play a big role whether or not youâll get arthritis along with your Crohnâs disease. Thatâs because Crohnâs might raise your bodyâs risk for luminal microbiota. These are organisms that can trigger arthritis.
Experts refer to the types of Crohnâs-related arthritis as âseronegative spondyloarthropathies.â This is a family of joint conditions. It includes:
- Ankylosing spondylitis
- Reactive arthritis
- Undifferentiated spondyloarthritis
Ankylosing spondylitis has a strong tie to a certain type of gene called HLA-B27. It controls your bodyâs immune response and itâs involved with Crohnâs disease.
Peripheral arthritis in people with Crohnâs disease also has a tie to HLA-B27, but itâs less strong. In this type of arthritis, thereâs a very strong link to a rare HLA gene called HLA-DR103. About 35% of people with large joint arthritis have this gene. In the overall population, only 1% to 3% of people have HLA-DR103.
Doctors donât know the exact reason these genetic ties lead to arthritis in people with Crohnâs disease. One theory is that regular arthritis flares result from a leaky, inflamed gut. This, plus your genetic risk for certain bacteria, could explain the link.
These things lead to uncontrolled inflammation in your system that targets your joints. Your arthritis risk likely depends on a combination of your genes and exposure to certain bacteria.
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Conditions That Cause Lower Back Pain And Constipation
It is also possible that you do not have IBS, but have constipation, which is also linked to lower back pain. Both constipation and lower back pain are fairly common medical issues, and are often nothing to be concerned about, but if they occur suddenly at the same time, it is advisable to see a doctor, as it might be a sign of a more serious issue. For example, the following are examples of conditions that cause both constipation and lower back pain to occur at the same time:
- Bowel obstruction
A bowel obstruction is a gastrointestinal condition in which digested material cannot pass normally or as it should through the bowel. A bowel obstruction can be caused by fibrous tissue that compresses the gut, which can develop many years after abdominal surgery. With a bowel obstruction, the blockage in your colon or rectum can create a dull pain that extends from the abdomen to the lower back.
Endometriosis is a condition in which the tissue that normally lines the uterus grows outside the uterus. In individuals with endometriosis, the tissues that should be lining the uterus can be found on the ovaries, fallopian tubes, or the intestines. Bowel symptoms are very common with endometriosis, as is back pain. This is because endometrial cells can stick to the lower back and the front of the pelvic cavities.
- Liver disorders
- Urinary tract infections
Ankylosing Spondylitis And Crohns Disease
When fusion occurs, axSpA progresses into ankylosing spondylitis , a subtype of axSpA that causes inflammatory back pain and limits range of motion. If AS causes significant fusing in the vertebral column and affects rib movement, the person may also struggle to take deep breaths.
From 1 percent to 6 percent of people with Crohns disease also have AS. Although doctors arent entirely sure what causes AS, some research suggests that genes may play a role in the diseases development, perhaps triggered by bowel or urinary tract infections.
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What To Know About Crohns Disease And Cramps
Here are nine things you should know about Crohns disease and cramps:
1. Abdominal cramps can occur anytime. Cramping can start during a flare or when youre in remission, says Jessica Philpott, MD, PhD, a gastroenterologist at Cleveland Clinic in Ohio. When Crohns disease is active, inflammation can change nerve and muscle function in the intestines, Dr. Philpott says. Even after inflammation is reduced, the functioning of the gastrointestinal tract remains altered.
2. Cramps can be caused by a variety of sources. Pinpointing the origin of cramps can help you treat the source, says Susan Coe, MD, a gastroenterologist with the Gwinnett Medical Center in Lawrenceville, Georgia. For example, if active Crohns disease is causing your cramps, treatment should be geared to reducing inflammation and treating any Crohns disease-related complications, such as a bowel blockage or fistulas, Dr. Coe says. Your doctor may recommend medications to help ease your symptoms during a flare and put the disease into remission afterward. If your cramping is from a stricture, which is the narrowing in a section of the colon, a low-residue, low-fiber diet can help, says Sandra M. Quezada, MD, an assistant professor of medicine in the division of gastroenterology and hepatology at the University of Maryland Medical Center in Baltimore. Foods low in fiber dissolve and pass through narrowed areas of the colon more easily, she says.
Axial Spa According To Asas Criteria
Six patients had LBP and sacroiliitis on CT and/or MRE and responded to ASAS criteria for the diagnosis of axial SpA. Of these 6 patients, only one had inflammatory LBP. All these patients had CD. The 2 patients with negative HLA-B27 status did not meet the clinical criteria of axial SpA, while the HLA-B27-positive patient presented both inflammatory LBP and sacroiliitis on both digestive imaging methods.
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What Causes Ankylosing Spondylitis
About 95% of people who have AS have a variation of the human leukocyte antigen-B gene . This changed, or mutated, gene produces a protein called HLA-B27 that increases disease risk. However, most people with a mutated HLA-B gene dont get AS. In fact, 80% of children who inherit the mutated gene from a parent with AS dont develop the disease. More than 60 genes have been linked to the condition.
Having one of these conditions may also increase your risk:
What Is Crohns Disease Exactly
Crohns disease is one form of inflammatory bowel disease , which includes other conditions such as ulcerative colitis, according to the U.S. National Library of Medicine . IBD happens when your immune system mistakenly attacks healthy cells in your digestive tract and causes chronic inflammation, setting off a slew of symptoms, as well as possible complications if the disease isnt treated.
Researchers believe this autoimmune reaction occurs when your immune system has an abnormal response to bacteria in your digestive tract, but why this happens isnt entirely understood. Over time, chronic inflammation can cause visible damage to the digestive tract, which can be seen on scans, Benjamin Lebwohl, M.D., gastroenterologist and associate professor of medicine at Columbia University Vagelos College of Physicians and Surgeons, tells SELF.
Crohns in particular causes inflammation anywhere in your digestive tract . However, it most commonly affects the small intestine and the large intestine .
Its not clear why some people get Crohns disease and others dont, but experts suspect genetics might be involved since the condition can run in families, according to the NLM. In fact, scientists have found more than 100 genes that are associated with having IBD, but more research is needed to understand the link1.
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Diagnosing Back Pain In Ulcerative Colitis
Diagnosing back pain as a symptom of ulcerative colitis can be tricky. Back pain can be attributed to a number of causes, including injury and strain. Because of the other potential causes, some people may not think to mention their backaches when seeking care for their UC. Whats more, back pain may develop years before UC does, making it more challenging to note the connection between the two.
If your doctor suspects that your UC has led to axial arthritis or ankylosing spondylitis, they will likely ask you to come in for a physical exam and tests. During this exam, they may test the range of motion in your spine and gauge your ability to take a deep breath. The doctor may also try to pinpoint the location of your pain by moving your legs or pressing on certain areas of your pelvis.
Radiographic tests are also commonly used to diagnose axial spondyloarthritis. Your doctor may use an X-ray to check for damage to your bones or joints. If no inflammatory damage is visible on the X-ray, your doctor may also order an MRI scan to get a more detailed view of your soft tissue and bones. An MRI scan can be particularly helpful, as it can allow doctors to catch and start treating your axial arthritis or AS before damage becomes extensive.
What Prevail Causes Of Lower Back Pain
Typical reasons for low back pain include lumbar stress, nerve inflammation, back radiculopathy, bony infringement, as well as conditions of the bone and joints. Each of these is evaluated below.
Back stress : A back pressure is a stretch injury to the ligaments, ligaments, and/or muscles of the lower back. The extending incident lead to tiny rips of varying levels in these cells. Back stress is thought about among the most usual sources of lower neck and back pain. Crohns Lower Back Pain
The injury can take place as a result of overuse, inappropriate usage, or injury. Soft-tissue injury is commonly classified as severe if it has actually existed for days to weeks. If the stress lasts longer than 3 months, it is referred to as chronic. Back stress usually occurs in individuals in their 40s, yet it can happen at any type of age. The condition is identified by localized pain in the lower back area with start after an occasion that mechanically emphasized the lumbar cells. The extent of the injury varies from light to serious, depending upon the degree of strain and also resulting spasm of the muscles of the lower back.
The medical diagnosis of back stress is based upon the history of injury, the place of the pain, as well as exemption of nerves injury. Usually, X-ray testing is just valuable to exclude bone irregularities.
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