Your Gut – Check the Symptoms

Your Gut – Check the Symptoms

This information is for anyone with axial spondyloarthritis (axial SpA) including people with ankylosing spondylitis (AS)

7% of people with axial SpA also develop inflammatory bowel disease

If you develop symptoms which might indicate inflammatory bowel disease (IBD) you should be referred by your GP or rheumatologist to a gastroenterologist for tests, diagnosis and ongoing management.

The main symptoms of inflammatory bowel disease are:

  • Diarrhoea. Passing looser poo more often than is normal for you.
  • Blood in your poo.
  • Urgency. Needing to reach a toilet quickly.
  • Waking up in the night to poo.
  • Cramping pains in the abdomen. These can be very severe and may occur when you need to poo.
  • Extreme tiredness, also known as fatigue.
  • Feeling generally unwell. Some people may feel feverish.
  • Loss of appetite and loss of weight. Weight loss can be due to the body not absorbing nutrients from the food you eat because of the inflammation in the gut.
  • Anaemia (a reduced number of red blood cells). You are more likely to develop anaemia if you are losing a lot of blood and are not eating.


There are two main types of inflammatory bowel disease: Crohn’s disease and ulcerative colitis.

  • Crohn’s disease

Crohn’s disease is a long term condition that causes inflammation of the digestive system. The inflammation can affect any part of the digestive system, from the mouth to the back passage, but most commonly occurs in the last section of the small intestine (ileum) or the large intestine (colon).


  • Ulcerative colitis

Ulcerative colitis is a long term condition where the colon becomes inflamed. In more severe cases, painful ulcers may form on the lining of the colon. These ulcers can bleed and produce mucus and pus.

Everyone experiences Crohn’s disease and ulcerative colitis differently. Symptoms can range from mild to severe. The conditions are very unpredictable. Most people have times when symptoms are largely under control known as remission, and flare-ups when symptoms are more active.

There is currently no cure for Crohn’s disease or ulcerative colitis. However, medicine, surgery or a combination of both can help to keep you feeling well and your symptoms under control.

Check your symptoms

If you think you might have symptoms of inflammatory bowel disease then do try the Crohn’s & Colitis UK Symptom Checker. You can print a copy of your results and take them along to your GP to help you discuss your symptoms.

Learn more

Learn more about Crohn’s and Ulcerative Colitis in this Facebook Live with Jaina Engineer, Knowledge and Evidence Manager at Crohn’s & Colitis UK

Consultant Rheumatologist Professor Karl Gaffney ran a Facebook live about other conditions axial SpA can cause, including gut problems:

Learn more about gut bacteria and our health with Microbiologist Professor Julian Marchesi

Help and support

Crohn’s & Colitis UK is a charity that provides help and support for people with IBD.

Their Helpline number is 0300 222 5700 (Monday-Friday 0900-1700). You can also contact them by email:

Symptoms starting slowly

Pain in the lower back

Improves with movement

Night time waking

Early onset (under 40)