Flaring without the big D

Depends on what you mean by asymptomatic. Maybe your DH is not paying attention to things that he's feeling - but if he thinks back to how he felt before the crisis you might discover clues.

I am not one who gets a lot of D. My diagnosis came about because I was passing blood and mucous, but that was after a good 6 months of nausea, lactose intolerance and gas. Nowadays my flares are more about joint pain then anything else, but fatigue is absolutely a big thing, and irregular bowels...like passing nothing for days and then having a lot of bowel movements in one crampy, horrible day.

Yes, most docs agree that joint pain associated with IBD means internal flaring, but good luck finding a blood test that will show that for sure. My inflammatory markers have never been very high, even when I'm in a lot of discomfort.

Joint pain for me started in my wrists and hands. At first I attributed it to hormonal cycles (my hands would hurt like heck for 1 day, two weeks later I'd menstruate). Then a few years ago I had hands-elbows-shoulders-knees-feet-jaw pain that sent me to a rheumatologist. He did a complete history, tested for rheumatoid arthritis & celiac, then called my GI and yelled at him for not treated my CD more effectively. I took pred for ~4 months, had another scope, revised my meds from Asacol to Pentasa and eventually switched GIs. The massive joint pain resolved with the pred, but my hands kept bothering me. I finally got fed up and told my GI that my joint pain was the most severe symptom of my illness. When I showed him that some of the joints in my hands and wrists were actually red and inflamed (those are the only times I've SEEN inflammation) he added sulfasalazine and that took care of the hands.

I had about a year of no joint pain until this March when my knee started aching. Over the last 6 months it's been knees-elbows-hands. Plus I have arthritic changes in my lumbar spine and sacroiliac joints. All of this is consistent with IBD. I cannot say for sure that the joint pain precedes a bowel flare (some people here have that experience) but I can say that the joint pain definitely goes along with more bowel symptoms. I am saddened by the fact that the arthritic changes in my back and pelvis will probably prevent me from ever doing regular aerobic exercise again, and I wish I could turn back the clock on that.

Yes. Since he has joint pain, I'd recommend getting a rheumatologist involved too. My rheumy is the best doc of all of my many docs, because he sees the big picture and will make the phone calls to my GI to push more/different/better treatment. My GI is never going to send me for an MRI to look for inflammation in my sacroiliac joint as my rheumy did last month.

My GI did finally respond to my complaints about my hands, but only when I showed him the red circle of inflammation on my wrist and pinkie. At that time I hadn't been to the rheumy for a few years, but if I'd gone when it first started I'd probably be tellling a different story today.

My rheumatologist is recommending biological therapy for me (remicaide or humira) but my GI says no. I still haven't resolved what to do. Your DH may be experiencing a new flare since his surgery - I can't remember what meds he's on, but joint pain does not bode well.

It depends on how he's feeling otherwise. He might benefit from a short prednisone treatment, but that might adversely affect his mood, which I think is something you're worried about. Prednisone would probably relieve the joint pain very quickly.

Son didn't get D or any particular increased trips to bathroom, for him it is pain(in stomach) and being unable to eat.