Jasbir Kaur Chahal’s Story – Ankylosing Spondylitis

Jasbir Kaur Chahal is a 51 year old lady from London, UK, who presented to us on 18 June this year, with a history of episodes of intestinal obstruction and abdominal pain. She had been to several centres in the UK for investigations and evaluations and finally chose to come to MIOT International for treatment.

Jasbir Kaur suffered from Ankylosing Spondylitis, a painful condition that affects the spine, for which she had been on prolonged use of non-steroidal anti-inflammatory drugs (NSAIDs) for pain-relief which, in turn, had caused a diaphragm disease.

The patient had been on liquid and low roughage diet for several months in order to avoid intestinal obstruction. The possibility of drug (NSAID)-induced diaphragm disease is a very rare condition.

On evaluation, CT enteroclysis and MRI enteroclysis revealed multiple strictures in the distal ileum. In order to confirm the findings and make a definitive diagnosis, a Double Balloon Enteroscopy had to be performed; this is a difficult procedure involving the use of an enteroscope, supported by balloons, and slid into the affected portion of the intestine.

Dr. Arulprakash, an expert in this procedure, chose the difficult option of going in through the colon, past the ileocaecal junction into the small intestine. Multiple areas of stricture were identified and biopsied.

The histopathology showed ulceration and submucosal chronic inflammation.

MIOT Hospitals