Đặc điểm lâm sàng, cận lâm sàng và hình ảnh nội soi đại tràng ở bệnh nhân viêm khớp cột sống tại Thái Nguyên

Ankylosing spondylitis (AS) is a chronic inflammatory disease characterized by inflammation of axial and peripheral joints, often accompanied by extra-articular manifestations, particularly within the gastrointestinal tract. Intestinal lesions associated with AS are crucial for patient prognosis and treatment guidance, especially concerning the selection of biological therapies. Early detection of these lesions, even in the absence of overt clinical symptoms, is essential for improving treatment efficacy and patients' quality of life. This study aims to describe the clinical, paraclinical, and specifically colonoscopic findings in patients with ankylosing spondylitis in Thai Nguyen, thereby providing vital data for disease diagnosis and management in the region.

Rheumatologists, gastroenterologists, general practitioners, medical researchers, and scientists interested in ankylosing spondylitis and its associated gastrointestinal pathologies.

This study aimed to describe the characteristics of colonoscopic lesions and related factors in patients with ankylosing spondylitis (AS) treated in Thai Nguyen. A cross-sectional descriptive study was conducted on 46 AS patients diagnosed according to 2009 ASAS criteria, at the Department of Rheumatology of Hospital A and Thai Nguyen National Hospital, from June 2024 to September 2025. Clinical findings revealed that joint pain predominantly affected axial joints, with peripheral joints, particularly in the lower limbs, being less frequently involved. Approximately 10.9% of patients reported gastrointestinal symptoms, mainly digestive disorders and abdominal pain. Significantly, colonoscopy revealed colonic mucosal lesions in 21.7% of cases, most frequently in the ileocecal region and rectum. Congestion and edema were the most common endoscopic lesion types, typically presenting as mild mucosal damage (10.9%). The study also identified significant correlations between age at disease onset, peripheral arthritis symptoms with HLA-B27 positivity, and gastrointestinal symptoms with endoscopic colonic lesions (p < 0.05). These findings underscore the importance of performing colonoscopy in AS patients to detect early intestinal lesions, even in the absence of overt gastrointestinal symptoms. Early diagnosis and timely treatment of these inflammatory bowel disease-related manifestations can significantly improve overall treatment outcomes and quality of life for patients, further clarifying the complex interplay between clinical presentations, genetic factors, and gut inflammation in ankylosing spondylitis.