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When I last saw a different GI whom my usual GI recommended, he supposedly has a strong background in Rheumatology.  His theory of my medical issues is that I have an inflammation problem in my body that causes multiple body parts to flare up at various times.  He believes that the inflammation has caused major issues for my digestive tract (Crohn's & Colitis) as well as a variety of other issues such as Psoriasis.   My long time lower back aching pain can also be attributed to it.

I am quarantined at home ATM as my daughter and I are stuffed up with cold symptoms.  We might possibly have Covid.  I went to bed last night around 11pm.  I woke up around 2-2:30am and changed shirts because I had sweat a fair bit.  I was also suffering from my usual aching / splitting back pain.  But this pain was as bad as it gets.   It made it very hard to (a) get comfortable and (b) get back to sleep.  I could barely manage either for the next 3-4 hours.  Then after getting up for my 3rd or 4th time diarrhea bowel movement, I decided at about 6am that I would take my 180mg of Codeine a bit earlier than usual so it would give me some back relief.  I go to the kitchen to take my pills and realize that I had forgotten to take my last dose at about 6-7pm!!!  It immediately made complete sense.  The night sweating, the splitting aching back pain, my increased diarrhea, and the overall terrible edgy feeling I was coping with.  I took my missed dose immediately and I am starting to feel better.  The question now is if / or when to take my next dose....  I will have to see how I feel...

If I forget to take a dose of my Codeine, the further away I get from it, the more I will suffer. 

For several years my weight would stay roughly between 162 and 168.  Over the winter break I stepped on the scale and I was 146.  A little bit of concern.  I am not worried about losing a little extra weight but I am more concerned about my muscle mass disappearing.

I just booked covid-test appointments for my daughter on Monday morning. If we had rapid test kits it would be way better / quicker but it appears there are none left anywhere around here...

P Pouch2021Member

Hi Capper,

I'm sorry you aren't feeling well. I'm not sure which part of your story you were seeking advice on so I apologize if this is unsolicited. A few things came to mind when I read your post. First, joint pain can certainly be associated with IBD (often called enteropathic arthritis and is typically considered under the umbrella of seronegative spondyloarthropathies, aka SpA). The arthritis can affect the spine and sacroiliac joints causing low back pain and can either following the trajectory of the IBD or flare independently from the gut. Enteropathic arthritis can also affect peripheral joints (knees, hands, etc).  Sacroiliitis is diagnosed by Xray or MRI of your SI joints. If present, it is often treated with NSAIDs if mild (avoided in most with IBD) or biologics. I guess my point is if someone has IBD and concern for inflammatory back pain there are tests that can be done to diagnose, and meds that can treat it and halt the progression of the disease, which can lead to SI joint and spinal fusion. You also mentioned you have psoriasis, so psoriatic arthritis (also a SpA) is possible and similar medications are often used to the arthritis and skin lesions. Chronic opioids such as codeine can address pain but but not the underlying inflammation. If there is a concern that you have joint pain related to IBD and/or psoriasis, I would see a rheumatologist.

Regarding the codeine and your symptoms overnight, I agree with you that it sounds like opioid withdrawal. Most will suffer worsening pain and often sweating, abdominal pain, nausea/vomiting and diarrhea if you stop taking opioids abruptly including missed doses when you have been taking them chronically. Another contributing factor to the increased pain may have been viral illness which can trigger flares of inflammatory arthritis.

Just some unsolicited thoughts on the subject! I personally would push for a more definitive diagnosis than an "inflammation problem."

Hope you feel better soon.

P

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