IBD and Peripheral Arthritis

Inflammatory bowel disease (IBD) is associated with several other conditions, including the liver disorder primary sclerosing cholangitis, fissures, fistulas, and arthritis. Arthritis is the most common extraintestinal complication, affecting an estimated 25% of all IBD patients. The two most common forms of arthritis experienced by IBD patients are peripheral and axial arthritis. Peripheral arthritis is most common in people with ulcerative colitis or Crohn's disease of thecolon. Typically, the course of the arthritis follows that of the IBD, with flare-ups and remissioncoinciding. There is no single test that can diagnose peripheral arthritis. Instead, several tests, such as blood tests,joint fluid analysis, and x-rays, are used to exclude other conditions that could be causing the symptoms. Symptoms of peripheral arthritis include:

Joint pain Swelling of the joints Stiffness in one or more joints Symptoms that migrate between joints

Peripheral arthritis tends to affect the elbow, wrist, knee, and ankle. When pain from peripheral arthritis is left untreated, it may last from several days to weeks; however, permanent damage to the joints is not usually found. Treating peripheral arthritis often involves resting painful joints along with splints and occasional moist heat. Exercises prescribed by a physical therapist are used to improve range of motion. Non-steroidal anti-inflammatory drugs (NSAIDs) are sometimes used to decrease the redness, swelling, and pain of inflamed joints -- but NSAIDs may aggravate the symptoms of IBD. Another method of treating this form of arthritis is to gain control over the inflammation in the colon due to IBD. The arthritis symptoms will usually lessen when the IBD is quiescent, and several drugs used to treat IBD may also be helpful for peripheral arthritis. IBD patients being treated with prednisone often get a bonus side effect of relief from joint pain. Patients receiving anti-tumor necrosis factor-alpha (anti-TNF) drugs, such as Remicade (infliximab) orHumira (adalimumab), to treat their IBD may also experience improvement in arthritis symptoms. Azulfadine (sulfasalzine), a 5Aminosalicylate drug that has long been used to treat IBD, may also provide symptom relief, although there is not much evidence to support its use. Another drug that is

prescribed to treat IBD, methotrexate, may also be an effective treatment for peripheral arthritis.

Reaction:
The article tackles about the relationship of Having Inflammatory Bowel Disease and Peripheral Arthrities with 25% of incidence rate. explained by the fact that one of the functions of the GI tract is to rid the body of dangerous substances. If this protective barrier is damaged, toxic substances can enter the body and cause inflammatory and rheumatologic diseases. These antigens can collect in the synovial fluid of the joints, which can cause a local inflammatory response. They can also enter the bloodstream and cause a reaction from the immune system itself, leading to damage in joints and other tissues of the body. Another, since the Peripheral Arthrisis is hard to diagnose, it was agrivatted by excessive use of NSAIDs that were used for the treatment of IBD. We can also say that Periperal Arthritis may be a warning symptom of IBD.

Papa, Jeaneleane C. EACC,Group 2