You have asked the $64,000 question. Keah and I have talked at length about
whether mild intestinal inflammation in a person with AS could look like Crohn's but be a manifestation of the AS. I'll tell you my story.
Bouts of intestinal problems for 20 years. Always told it was IBS. Also had bouts of odd joint issues - from tendinitis not due to overuse to bursitis not from overuse. Two bouts of iritis [heavily associated with AS]. Umpteen bouts of kidney stones [this associated with CD]. Finally started having odd joint issues, cysts in joints that had to be surgically removed, hips so inflamed I could not walk. Then came the duiarrhea from hell that caused me to seek medical attention. Scoped twice and was told by GI he could not understand my erosions in the terminal ileum - path report said highly suggestive of CD but GI not sure.
Sought out better GI who immediately diagnoses me with mild CD. Eight months later I have joint problems so bad I could not walk. Scheduled for hip replacement surgery. GI not convinced and based on my positive HLA B27 starts me on Remicade. Lo and behold, after the third infusion I put away the cane, walker, and wheelchair and canceled my surgery.
So I have AS but I also have pretty severe inflammatory erosive osteoarthritis. I have had multiple MRIs and my back is a mess. I am growing large bone spurs pretty much everywhere. I develop enthesitis in my shoulder, knee, thumb, and finger tendons. My Achilles used to get attacked frequently but they are so clacified now that they really aren't as bothersome anymore. I have had sacroiliitis which is a hallmark sign of AS but not necessary for a diagnosis according to some docs.
To top it all off and add confusion - my Crohn's has pretty much been in remission since I went on Remicade. Diagnosing enthesitis is pretty tough. It isn't always picked up on MRI. My rheumy uses ultrasound imaging to view my tendon insertion points.
I hope your rheumy takes your complaints seriously and helps get you some relief. Let me know what happens.
Moderator Crohn's Disease Forum
CD, Ankylosing Spondylitis, small fiber peripheral neuropathy, avascular necrosis, diffuse connective tissue disease, Sjogren's Syndrome ?