Hiya Molly,.. Gastro and AS are not always bedfellows and gastro upset with nsaids is not a 'given'.

I've had AS for 30 yrs and have never had gastro issues of any kind (except at initial onset for 1 day), so while GI issues are not uncommon with AS, to make such a blanket statement is making up facts.

"Subclinical gut inflammation has been described in up to two-thirds of patients with spondyloarthropathies (SpA)." Not three-thirds. smile

I've been taking NSAIDS for 28 years, every single day, non-stop as one treatment for my AS and have never taken a stomach protector medication. I never needed one. Why? Because there is nothing wrong with my stomach or intestinal tract. Maybe as I age ( eek ) this will change but I'm grateful for the 28 yrs of relief I've had and hate to imagine how I would have managed without.

"..about two-thirds of nonsteroidal anti-inflammatory drug users demonstrate intestinal inflammation." Again, not three-thirds.

Quotes source, PubMed abstract: Gastrointestinal lesions associated with spondyloarthropathies.

My rheumatologist did not prescribe stomach protector meds in my case because they are simply unnecessary. This is not neglect but quite the opposite - a recognition of the fact that not all patients are the same and not all patients respond to medications in the same way that you do. We are all different. Vive la différence!

Ack, Firefox is about to crash on me, again tongue4 so I'd better end here!