8 month gastro/vascular??? mystery and counting

I'm at my wits end with this medical mystery that is my body and would love some thoughts/advice/ideas!

33M (trans man, 4 months on T, no surgeries), 5'5", 240lbs, ended up admitted to hospital at the end of April 2025 for 10 days with severe abdominal pain and rectal bleeding. Pain was localized to lower left quadrant of the abdomen and got worse about 30-60 minutes after eating or drinking. Existing medical issues and meds before admitting: depression/PTSD (effexor 300mg, abilify 2mg), hypothyroidism (synthroid 100ug), fibromyalgia (gabapentin 600mg 2/day), iron deficiency (ferrous gluconate 300mg), acid reflux (pantoprazole 40mg).

CT scan found some sigmoid colon inflammation and 2 arteries (infrarenal abdominal and inferior mesenteric) were inflamed/thickened. Suspected vasculitis. Angio MRI later showed partial occlusion localized to those two arteries (no vasculitis diagnosis). 60mg prednisone was prescribed. Endoscopy and colonoscopy were conducted, finding again mild sigmoid colon inflammation and mild leukocytic colitis but nothing further.

High blood pressure and regular chest pain became a problem. Cardiologist seen, echo and stress test normal, bisoprolol 2.5mg and amlodipine 2.5mg prescribed, blood pressure returns to normal.

With blood tests and symptoms, diagnosed with SLE (lupus) August 2025, causing the artery problems. Prednisone discontinued and hydroxychloroquine 400mg was prescribed. At this point, abdominal pain is regular, almost constant, but not as severe - 5/10 on the pain scale, spiking to 8/10 after eating.

Cardiologist appointment in October to discuss the possibility of chronic colon ischemia. Says cholesterol is within normal range but puts me on rosuvastatin 10mg to keep it low. Referred to vascular surgeon consultation scheduled January 28.

For months I was able to balance the pain with smoking cannabis to work up enough of an appetite to try to force myself to eat. As of December 25 it stopped working. Pain spikes were so severe I could not eat anything past some juice and ensure drinks. Ended up at the ER January 4, where I was admitted for more testing and pain medication. Another CT was performed, showing no progression of the artery inflammation or thickening but also no improvement. I'm now waiting on GI to do a doppler ultrasound to check blood flow through the artery(ies?), as there is a suspicion of MALS.

Vascular team says they won't take my case as I have an outpatient consultation in 3 weeks, and since one of the arteries normally ends up clipped in an angioplasty situation anyways it doesn't matter, but I haven't eaten since December 25th and I'm in so much pain I can't stand it anymore. If they discharge me to wait til the end of the month I don't know how to manage without food at home.

Any ideas? To me it seems straightforward - chronic colon ischemia that could be fixed by an angioplasty/stent. But obviously I'm not a doctor.

Much thanks