A 40-year-old man with Ulcerative Colitis controlled on mesalamine reports new onset of severe lower back pain that improves with activity but worsens at rest. The pain is also associated with morning stiffness lasting for about an hour. What could this indicate?
The new onset of back pain that improves with activity and morning stiffness in a patient with Ulcerative Colitis could suggest ankylosing spondylitis, a type of inflammatory arthritis affecting the spine. This condition is more common in patients with IBD. He should be referred to rheumatology for further evaluation and management, which typically includes physical therapy and potentially immunosuppressive medication.