Gastrointestinal Symptoms Related to Rheumatoid Arthritis

What Is Rheumatoid Arthritis?

Rheumatoid arthritis (RA) is a system-wide inflammatory disease, which primarily affects the joints and several other organs. Roughly, 1% of Americans have rheumatoid arthritis, with smokers and women having a three to five fold-increased risk of developing the disease.

While the exact cause of rheumatoid arthritis is still unknown, most medical researchers agree the disease’s characteristic symptoms arise from a dysfunctional autoimmune response. In a normal immune response, the body’s main defenses against disease, B and T cells, will single out and destroy invading pathogens. In the immune system of a person with an autoimmune disorder, these same defenses fail to differentiate between pathogenic and non-pathogenic cells. As a result, healthy tissue, such as joint tendons and ligaments, can be targeted, resulting in arthritis-like symptoms.

While the rate of mortality from RA can vary widely depending on several lifestyle and health-related factors, many long-term sufferers find impairment in daily living activities and work. The common course of therapy for RA patients focuses on reducing the body’s immune response, and preventing further damage to joint tissue. Treatment involves taking anti inflammatory, pain relieving, and several other, more specialized, drugs. While no treatment for RA is 100% effective, these measures, taken with several key lifestyle changes (such as reducing smoking), can make the prognosis much less severe.

What are the Symptoms of Rheumatoid Arthritis?

Rheumatoid arthritis is primarily a disease of the joints, with the joints of the hands and feet most commonly affected. A sufferer of RA will notice tenderness, swelling, and reddening of the affected joints, in addition to stiffness. Over time, more of the small joints become symptomatic, which can lead to a loss of flexibility, stiffness, and pain. Eventually, the joints themselves can take on a “deformed” appearance, and all function can be lost.

RA can also affect the lungs, skin, and kidneys. Small skin nodules can appear over joints with bony prominences, with purplish marks (vasculitis) appearing as the disease progresses. The lungs can become less effective, as RA causes a buildup of fibrous tissue. Finally, the Kidneys can accumulate plaque (fribrosis), which lowers their overall function. While these three organs seem to have the most commonly seen complications from RA, many other tissues- the eyes, liver, and nervous system- can have complications from the disease.

Possible Gastrointestinal Symptoms Related to Rheumatoid Arthritis?

With the diverse range of body systems affected by RA, many people wonder if any possible gastrointestinal symptoms related to rheumatoid arthritis exist. As mentioned, some elements of the gastrointestinal system (namely, the liver) might have a chance of complications from RA. However, classic “gastrointestinal symptoms”, such as those involving the stomach, small, and large intestines, are not commonly associated with the disease. Sun et al failed to find any correlation between RA and upper GI disease, while another study from Modern Rheumatology actually found that having RA might decrease common stomach infections.

Although it is difficult to find a direct relationship between rheumatoid arthritis and Gastrointestinal disorders, there are a few indirect possibilities. One potential link between RA and GI disorders might come from a lack of saliva. Many sufferers of rheumatoid diseases (including RA) develop Sjögren’s syndrome, or “Sicca”, a condition marked by dry mouth. Saliva itself plays a crucial role in several aspects of the GI system, and a lack of it can cause esophageal and stomach irritation. However, the strongest link between RA and GI symptoms might come from the medication one takes to treat RA. NSAIDs, or non-steroidal anti-inflammatory drugs, can carry the risk of stomach inflammation and ulcers. These symptoms can be alleviated by stopping use of the drug, although RA symptoms than have the chance of flaring up. While there is no definitive proof that RA causes GI disorders, patients with RA should take care to monitor possible irritants in their diets and in the medications they take. Patients with a history of GI symptoms will need to discuss possible medication side effects with their doctors.

References

1. Majithia V, Geraci SA (2007). “Rheumatoid arthritis: diagnosis and management”. Am. J. Med. 120 (11): 936–9. doi:10.1016/j.amjmed.2007.04.005. PMID 17976416

2. David C. H. Sun, Sanford H. Roth, Charles S. Mitchell, DeWitt W. Englund. “Upper gastrointestinal disease in rheumatoid arthritis”. Digestive Diseases and Sciences. Volume 19, Number 5 / May, 1974

3. H. Nakamura, E. Mukai, D. Hirano, T. Matsuhisa, N. Yamada and S. Yoshino. “Gastrointestinal disorder and Helicobacter pylori infection in patients with rheumatoid arthritis”. Modern Rheumatology. Volume 11, Number 1 / March, 2001