Understanding Enteropathic Arthritis

When you think of arthritis, you probably picture stiff, achy joints. Gastrointestinal problems may not immediately come to mind. Yet enteropathic arthritis, a chronic illness that is one of a family of diseases known as spondylarthritides, actually is associated with Inflammatory Bowel Disease.

How can the gastrointestinal tract be connected to arthritis? According to the Spondylitis Association of America, the gastrointestinal tract is home to the body's largest immune system. When people have an inflammatory bowel disease such as Crohn's disease or ulcerative colitis, their intestines are likely to be damaged. This may allow bacteria to enter the bowel and get into the bloodstream. What happens next? The bacteria cause systemic inflammation, and sufferers experience problems in other areas of the body. The limb joints are typically affected, although the spine can be impacted as well. People with enteropathic arthritis also may get sores on the skin or have eye problems. Estimates are that about 13 percent of people with inflammatory bowel disease also have enteropathic arthritis.

Enteropathic arthritis can be mild or severe, and it tends to flare up at recurring intervals of about six weeks. The disease, like other spondylarthritides, has a genetic component. Doctors typically will ask about family history when considering a diagnosis of enteropathic arthritis. Other means of diagnosis may be a stool culture, colonoscopy, joint x-ray, blood test to check for inflammation, and examination of joint fluid.

Unfortunately, there is no cure for enteropathic arthritis. However, certain therapies have yielded good results. They include:

Practicing good posture. Standing correctly can help avoid complications of the disease, especially when the spine is involved. And exercises that work on flexibility can be a boon, too. A good physical therapist can guide patients in this area.

Applying heat and cold. Heat can help with tight joints and muscles, and cold can reduce swelling in inflamed areas.

Taking medication. The typical treatment for arthritis, non-steroidal anti-inflammatory drugs, often cannot be used with enteropathic arthritis sufferers because those drugs irritate the lining of the intestine. Patients should talk with their doctors about alternative medications such as sulfasalazine, which works on not only joint pain and swelling but also the intestinal lesions that are the hallmarks of inflammatory bowel disease.



Spondylitis Association of American, www.spondylitis.org

National Institutes of Health, www.ncbi.nlm.nih.gov