Navigating GI and AS Symptoms After a Trip to São Tomé and Príncipe | Should I Be Concerned?
Hello everyone, I'm seeking some guidance or to connect with those who may have had similar experiences because I'm feeling quite unwell and uncertain about the seriousness of my symptoms and the necessity to visit a healthcare professional. As a 27-year-old male diagnosed with ankylosing spondylitis (HLA-B27 positive), I've just returned from a 15-day honeymoon on the island of São Tomé, located off the west coast of Africa. Toward the latter part of my holiday, I began experiencing gastrointestinal problems, primarily diarrhea and a general discomfort in my stomach. To cope with it, I took some anti-diarrheal medication (Aero-OM) alongside Atyflor. While the diarrhea subsided, post-flight home (this past Monday), I began to face nausea and vomiting, leading to a noticeable decline in my condition. I struggled to sleep on the overnight flight, and despite trying, I also failed to find restful sleep the night after returning due to my upset stomach, culminating in me vomiting around 4 AM. However, I've managed to get about 10 and 9 hours of sleep over the last couple of nights, respectively. Currently, my symptoms include: • Severe fatigue, requiring frequent rest even after minimal exertion • Lengthy sleep duration (8–10 hours) yet still feeling exhausted • Low-grade fever fluctuating between 37.5–37.9°C • A constant urge to defecate with minimal bowel movement • Occasional burping, but no significant gas • Noticeable swelling around the knuckles, especially on my middle and index fingers, particularly when I make a fist, without any redness or pain, yet it feels different, resembling soft tissue or joint inflammation. There hasn't been any spinal discomfort during this time aside from fatigue, although I have experienced previous flare-ups in my SI joints and back. My primary concern now is that this could be: • Reactive arthritis resulting from a gastrointestinal infection • A peripheral flare related to my ankylosing spondylitis due to an immune reaction • Or potentially an ongoing gastrointestinal infection (like a parasite or bacteria) I'm curious about how serious these symptoms may be and whether I should wait a bit longer before seeking emergency care. Additionally, I would like advice on the swelling in my knuckles. Any assistance or insights would be greatly appreciated! Thank you!
Answers (1)
8/7/2025, 10:01:45 PM
OpenHealth AI
It sounds like you're experiencing a combination of gastrointestinal symptoms and potential joint issues after your trip, which can understandably be concerning. Based on your description, there are a few potential causes for your symptoms, and it's important to address them carefully.
Summary of Main Points:
- Your current symptoms could be related to a gastrointestinal infection, reactive arthritis, or an inflammatory response due to ankylosing spondylitis.
- Monitoring symptoms is crucial, and certain symptoms require more immediate attention.
Explanation:
Given your recent travel and the onset of symptoms, you might be dealing with an infection, possibly gastrointestinal. Your history of ankylosing spondylitis makes you more susceptible to reactive symptoms, which could explain the swelling in your knuckles. The fever, fatigue, and gastrointestinal issues are significant and warrant appropriate management to avoid complications.
Prioritized Next Steps:
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Hydration: Ensure you are drinking plenty of fluids to stay hydrated, especially after vomiting and diarrhea. Water, herbal teas, and electrolyte solutions are good options.
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Monitor Your Symptoms: Keep track of your fever, the frequency of your bowel movements, and any changes in joint swelling or pain. Note if you experience any new symptoms such as severe abdominal pain or blood in your stool.
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Diet Adjustment: Stick to a bland diet (e.g., bananas, rice, applesauce, toast) to help settle your stomach. Avoid dairy, fatty foods, and spicy meals until you’re feeling better.
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Rest and Recovery: Continue to rest as needed and allow your body to recover. Listen to your body’s signals and avoid overexerting yourself.
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Seek Medical Attention if Necessary: Given your combination of symptoms—persistent nausea/vomiting, low-grade fever, significant fatigue, and joint swelling—if you continue to experience these symptoms for more than another day, or if they worsen, seek medical attention. Specifically, seek care if:
- You develop high fever (over 38.5°C/101.3°F)
- You experience severe abdominal pain
- Bowel movements are bloody or include mucous
- Joint swelling is painful or limits your mobility
In Conclusion:
You’re right to be attentive to these symptoms, especially after experiencing gastrointestinal issues while traveling. Your health needs to come first, so monitor how you feel closely and do not hesitate to seek medical care if your conditions worsen or fail to improve. Take it one day at a time, and prioritize rehydration and rest as you recover.
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