Are Ankylosing spondylitis and Ulcerative colitis interrelated?

I am a 32 years old male under treatment for ulcerative colitis from last three years. I get little blood with mucous in stool and difficulty in passing gas sometimes. I also have lower back pain. I have been diagnosed with ankylosing spondylitis and the HLAB27 blood test is positive. I have not yet started taking treatment for ankylosing spondylitis. I am taking Mesacol 2-2-2 (400MG) currently. My steroid course for ulcerative colitis got over long back. Are ankylosing spondylitis and ulcerative colitis interrelated?

 

I note that you have ulcerative colitis (U.C.) and that you have had a relapse recently and there is associated back ache. As you would have been informed by your physician that U.C. is a chronic condition with periodic relapses. What determines a relapse is difficult to predict, it could be anything from stress to infection. The best thing to do is to increase the dosage of Mesalazine as well as use mesalazine foam/ suppositories or enema, if available, after discussing with your physician. If this does not help, you will have to use steroids as you have done in the past.


The second aspect is back pain. Association of sacro-ilac joint inflammation and there by pain is well documented in U.C. and usually the pain subsides when the bowel symptoms get controlled. Using analgesics (pain killers) helps but anti inflammatory pain killers are best avoided as they may sometimes worsen the bowel symptoms. Ankylosing spondylitis is a condition known to be associated rarely with ulcerative colitis but more commonly with a similar bowel condition called Crohn's disease, and this would mean that you need to have colonoscopy and appropriate biopsies to determine the type of colitis you have, either Crohn's colitis or ulcerative colitis. In the former, the inflammation involves the whole thickness of the bowel wall but in U.C. only the lining gets inflamed, and if does not settle with tablets surgery needs to be considered. After having said all this, the recent therapies with newer drugs which act specifically against inflammatory cytokines at cellular level in the bowel mucous membrane have shown great promise and you need to see a specialist for this. Good luck.