I gather that this disease is different for everyone it sounds. I don't know anyone personally that has it. I have no gut involvement. I have taken NSAIDS for 25 yrs on my own(over the counter). Fortunately my stomach is no worse for the wear. I don't under stand the term " flare." My pain is consistent all the time. It has gotten worse over the last couple of yrs, but it stays consistent, no up and downs. All of my pain so far has been from the belt line up thru the Neck. I have had no pain in the SI joint, but in the last couple of weeks I have had some burning in the muscles across my SI joints. I have had some odd things going on since I started this medicine, but as of know I too think the relief is worth it. I am just hope that there is an adjustment period and things will get better. It feels like some days that there is a war going on inside my body. It like those muscles are trying to stiffen up but they cant.