About 40 to 50 percent of people who have inflammatory bowel disease (IBD) experience joint pain and inflammation. Arthritis is a condition that can lead to damage and permanent loss of mobility in the joints.
Patients with Crohn’s disease or ulcerative colitis can develop arthritis as a result of their intestinal inflammation, although this is only about 20% of those diagnosed. The majority of IBD patients who develop arthritis have a gastrointestinal condition that affects only one part of their intestines, such as rheumatoid arthritis or psoriatic arthritis.
The exact cause of arthritis in IBD is not known, but it has been associated with a number of disorders and diseases that can affect the body’s immune system. These conditions include autoimmune diseases, bacterial infections of the gut and parasitic infections.
There are two types of arthritis that are often associated with IBD: peripheral and axial arthritis. Both of these conditions are characterized by swelling, redness and pain in the joints.
Peripheral arthritis usually occurs with flare-ups of the bowel, but it can also occur by itself without any bowel symptoms present. Typically, if the pain and inflammation are treated, the bowel inflammation resolves as well.
Axial arthritis, on the other hand, involves a person’s spine and often causes severe pain. This type of arthritis is often associated with severe low back pain, but it may also cause stiffness and joint inflammation in other areas of the body.
Both of these conditions can be treated with medications, such as nonsteroidal anti-inflammatory drugs (NSAIDs), that are used for pain relief. These drugs can also help with bowel inflammation.
Some patients may need surgery to repair damaged or destroyed bones and joints. This can help improve a patient’s overall quality of life.
If the arthritic condition is caused by an infection, antibiotics are usually prescribed to treat the infection. Medications that can help prevent infections and heal wounds, such as ibuprofen or naproxen, are also sometimes prescribed to reduce the pain and inflammation of the joint.
Treatment depends on the type of IBD arthritis that is present and whether it is affecting the small or large joints in the body. Depending on the type of IBD arthritis, the condition can be treated with either medication or surgery.
NSAIDs are the most commonly prescribed drug for pain and inflammation of the joints in patients with IBD arthritis. However, these drugs can aggravate gut inflammation and can increase the risk of stomach or ulcer damage in some cases. Newer NSAIDs that are “COX-2 selective” have been shown to be effective at lessening the risk of stomach and ulcer damage in these patients.
Other options for treating arthritic conditions associated with IBD are physical therapy or exercise therapy and anti-inflammatory medications such as steroids or steroid creams. These treatments can help with pain and inflammation, but they don’t usually prevent the need for surgery.
In addition to examining the joints for swelling and limited motion, your doctor may order X-rays of the involved joints to see if there is any damage to the bones. In some cases, your doctor may recommend blood tests to look for a range of inflammatory markers, such as C-reactive protein and interleukin-6. The blood test can be used to diagnose a number of inflammatory conditions and help determine the best course of treatment.
