Ankylosing Spondylitis, IBS D, and Irisitis/Uveitis

[Usaf9498]

I served in the USAF from 1994-1998. Deployed to Bahrain, Turkey and Saudi, and was at Khobar Towers in 1995 when it was bombed. I am currently rated at 90% total. 70% PTSD from the bombing, 50% sleep apnea secondary to PTSD and 10% Tinnitus. 

I have suffered from IBS for over 20 years. It was finally getting bad enough this spring that I went to the VA and talked to my primary care. She ordered a colonoscopy and referred me to the GI department. Colonoscopy came back relatively normal, with a few polyps removed and biopsied all coming back negative. They put me on fiber twice a day which has improved my issue a little. My GI nurse told me in a video conference yesterday that she was finally officially diagnosing me with IBS type D.

About the same time I was having the worst of the IBS issues this spring, I also started having severe joint pain. I was referred to rheumatology and was sent in for a CT scan, and gobs of blood work and x rays. They diagnosed me with Ankylosing Spondylitis. My bloodwork did show that I am HLA-b27 positive, but have no family history of AS or any type of auto immune diaseases. I am injecting myself in each leg once a month with 300mg Cosenyx. The injections help but they are talking about adding a pill to help get it under control 100%. It is really affecting my knees, my thumbs, and my ankles the most and I am afraid of it getting worse. I drive a truck for a living and I really need my joints to work to continue to provide for my family. 

During the Xrays of everything, they found several masses in my lungs. They did a CT scan and said that they were likely not cancerous, but wanted to do follow up tests in a year to compare to make sure nothing was growing. I was a smoker for a few years so I cannot say that is from the sand but who knows? 

For about the last 3 years, I have had a few bouts of irisitis/uveitis which my civilian opthamologist said was likely rheumatoid arthiritis. It is also a common side effect of my AS. I take a steroid eye drop when I have flares and when I catch it quick enough, knocks it out before it gets really bad. I have had one flare up since I have been going to the VA, and had them look at it and document it, and now get my prescription eye drops from the VA.  

I know IBS is a Gulf War Presumptive. I am wondering if my AS would be condsidered GWP also? Would it be secondary to my IBS? Should it be a stand alone claim and the irisitis be secondary to AS? I am not the kind of guy that is trying to claim everything wrong with me is somehow a VA claim, but this stuff just has gotten the better of me and I can see no reason why I am having these issues. 

As always, I appreciate all of the help!

 

 

 

[Rattler]

On 11/26/2020 at 3:35 PM, TexasVeteran said:

I'll have to disagree here sir. People with AS or IBS both typically have the HLA-B27 marker. And those with AS are more likely to develop IBS (5-10 percent of people with AS develop IBS according to Joel Taurog, MD from a 2013 EverydayHealth article). 

Your AS should be the primary and IBS secondary. If you have pain in your back, neck, hips, and/or knees, you will need to be rated for for those separately. You will need to get an Independent Medical Opinion and Nexus letter completed by someone like Dr. Ellis out of Oklahoma City (Ellis Clinic). Stating his opinion of the nexus between your AS and military service and the connection between your AS and IBS. It's probably not unreasonable to say that it is "more likely than not" your IBS is due to or made worse by your serviced connected AS condition.

Dr. Ellis would be your very last stop and you should have a complete case file before going with medical records (military, va, and private), diagnosis letters, buddy letters (multiple, from family, friends, and co-workers), work absentee letters, appeals cases close your case, and any medical journal articles which support your claim and connection from AS to IBS. Having all of that should be a rock solid case.

Before you go to your C&P exam, be sure to download the DBQ's they will be using to evaluate you. Those are no longer available on the VA's website, but are archived here: https://helpdesk.vetsfirst.org/index.php?pg=kb.page&id=3300  (google: "vetsfirst DBQ 3.1").  Be prepared for all the questions they could ask from that form and understand how you will be rated by researching each condition's rating criteria, simple google search on that.

https://www.everydayhealth.com/ankylosing-spondylitis/inflammatory-bowel-disease-and-ankylosing-spondylitis.aspx

 

One of the best well written answers I have seen. Good Job  TexasVeteran.