MRI- sacroiliitis, small bowel normal- huh?

My GI informed me that my small bowel MRI was normal, no sign of Chrons. But it showed inflammation in my lower back, called it sacroiliitis. 

Is there good reason to pursue a pill cam when my MRI was normal? It sounded like he was going to do no further evaluation. I have severe tummy issues that alternate from c to d. Bloating, pain. Normal colonoscopy, but in my biopsy there was a high white blood cell count.

Now about sacroiliitis, I didn't even know it existed. I saw a primary care practitioner yesterday who was just wonderful and she is looking at my symptoms as a whole...we are doing the HLA labs and all the Rhumy labs? I have joint pain in my feet, knees, hands, wrists...and back. I had no idea my lower back issues had a name! It is weird, but I am glad to know. There are days where it is excruciating to walk or bend over. It is the absolute worst in my first trimester of pregnancy. I had seen a physical therapist who brushed me off (and it was the most painful appt EVER) telling me it was loose ligaments from pregnancy hormones. After my third pregnancy the lower back pain stayed. If I get overactive I set it off. Like if I try to race my 5 year old son. Sigh. I recently had a massage and adjustment at the naturopath, and they did great everywhere else, but both really worked on my lower back and showed me exercises to do- oh my gosh I was DYING. And then some days I wake up with no pain, just stiff in my legs, hands and feet. I thought I was insane because I am only 27...my PCP is looking into AS and Reiters syndrome I guess. Googled them and AS seems more likely. Anyone wish to share experience here?

I have to figure out how to talk to my GI. I did the Celiac panel in December and it was negative, so he wasn't even going to pursue that. But 2 years ago my results elsewhere were called equivocal, due to positive iga and igg levels.

Is an MRI conclusive for IBD? Or is it nessecary to view the small bowel to look for ulcers?

I'm so confused. Miserable but staying positive! Lol.

-Megan

I have Ankylosing Spondylitis [AS] and Crohn's disease. Which disease came first is hard to say. I have had symptoms of both for over 35 years.

Many people with AS have intestinal issues. Some get diagnosed with Crohn's.

Sacroiliitis can be so very painful. I cannot sit for any longer than 10 minutes at a time and if the SI joints are really inflamed, I cannot sit at all. I stand and keep moving almost all day otherwise I get very stiff. Prior to my current medication, I suffered from frequent enthesitis in many tendons. Enthesitis is tendinitis at the point where the tendon inserts into the bone. Left untreated, repeated bouts of enthesitis in a tendon causes it to calcify limiting mobility. I have lots of calcified insertion points. My Achilles tendons are calcified for a couple inches up the back of legs from the heel. It makes it really important to stretch before doing anything strenuous, otherwise I can tear them.

When I was diagnosed with Crohn's, it was classified as mild. Then within a year I had terrible pain in my right hip and SI joints. My hip pain became so bad that I was scheduled for hip replacement surgery. I could only walk using a walker. I needed help to get on and off the toilet. My GI and later my rheumy, became convinced that this was spondyloarthropathy [SpA] associated with Crohn's. I was started on Remicade. After my third infusion I was walking without any assistance. I could squat down, hind end almost to the floor - something I had not been able to do for two years. The hip replacement surgery was canceled!

Currently, I take Simponi for my AS. It is a newer anti-TNF. It also seems to keep my Crohn's in control. I have had two flare ups in my SI joints while on Simponi. Both of these occurred when I had huge amounts of physical and emotional stress.

You need to be evaluated by a rheumatologist. Try to get one that has experience with AS. It is likely that if your SI joint inflammation is gotten under control, your intestinal problems will lessen.