Hi and thanks for the query, It would have been interesting to know exactly the results of the colonoscopy. Muscle pain and fatigue under these circumstances, especially if accompanied by some abdominal or gastroinetstinal symptoms could be a possible manifestation of Crohn s disease or ulcerative colitis. Muscle pain, joint pain and fatigue are commonly observed non gastrointestinal or abdominal manifestations. A complete work to rule out rheumatologic disease should be investigated once again. Its true that lupus is ruled out, but other systemic disease like vasculitis, mixed connective tissue disease and other diseases related to the Human Leucocyte Antigen 27, HLA27 generally do present as too. A clinical review again by an internist and probably a rheumatologist could give a more holistic view of future management and diagnosis directions. I pray you not to get discouraged as of now, for there is still much that can to be done to get the actual diagnosis and \manage appropriately. Thanks and kind regards. Bain LE, MD.