Crohn’s disease is a condition of the digestive system characterized by inflammation that occurs most commonly in the colon. However, it can affect any gastrointestinal site from the mouth to the anus. Crohn’s falls under the umbrella term “inflammatory bowel disease” (IBD).
The inflammation caused by Crohn’s disease can also extend to other parts of the body, including the joints. Rheumatoid is one such inflammatory joint disease that has been recently linked with IBD. A review article published in BMC Gastroenterology concluded that patients with IBD, such as Crohn’s, are at a greater risk of developing rheumatoid arthritis (RA).
Researchers speculate three reasons why patients with IBD may also develop RA, which include:
- The shared disease processes related to a dysregulated immune system
- The common inflammatory pathways triggered in autoimmunity
- Some common genetic factors
Additionally, studies have linked both RA as well as IBD to the altered intestinal flora (dysbiosis); however, this mechanism requires further analysis.
Apart from RA, Crohn’s disease makes you more likely to develop other kinds of arthritis too. Studies show that arthritis can occur in 6 to 46 percent of patients with IBD, with spondylitis affecting 1 to 26 percent.
How do doctors treat rheumatoid arthritis caused by Crohn’s disease?
Doctors can treat rheumatoid arthritis caused by Crohn’s disease in several ways, such as:
Nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin or ibuprofen, can help relieve joint pain and swelling in rheumatoid arthritis, but they are harmful to patients with Crohn’s disease. They can worsen the symptoms of Crohn’s by irritating the digestive system, especially the intestines. The only safe drug that doctors recommend for minor pain is acetaminophen.
Common drugs that can benefit both Crohn’s disease and rheumatoid arthritis include:
- Biologic drugs (immunotherapy) such as
In addition, patients with rheumatoid arthritis due to Crohn’ disease can also use simple measures to alleviate their joint pain and swelling, such as:
- Resting the affected joint
- Icing and elevating the joint
- Physiotherapy exercises that strengthen the muscles around the joints and help relieve the stiffness
Because both Crohn’s disease and rheumatoid arthritis are caused by inflammation, the affected patients should avoid ingesting foods that trigger any inflammation, which include:
- Foods high in saturated fats
- Sugary foods
- Processed and packaged foods
- Fried foods
- Dairy products
Patients should find replacement options for these foods. For example, try switching to whole wheat substitutes of bread instead of bread made from refined white flour, and replacing red meat with foods rich in omega-3 fatty acids such as fatty fish (salmon, sardines and tuna).
Probiotics are also proven anti-inflammatory substances that are present in foods such as yogurt and kefir (a type of fermented drink). These foods can fight off gut inflammation caused by Crohn’s disease and thus alleviate the symptoms related to rheumatoid arthritis.
Patients with Crohn’s disease should let their doctor know if they experience joint pain, joint swelling or joint stiffness. Some medications used for Crohn’s are also known to cause osteoporosis, which can result in joint pain.
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Salem F, Kindt N, Marchesi JR, et al. Gut microbiome in chronic rheumatic and inflammatory bowel diseases: Similarities and differences. United European Gastroenterol J. 2019;7(8):1008-1032. doi:10.1177/2050640619867555
Orchard TR. Management of arthritis in patients with inflammatory bowel disease. Gastroenterol Hepatol (N Y). 2012;8(5):327-329.
Clinical manifestations and diagnosis of arthritis associated with inflammatory bowel disease and other gastrointestinal diseases. https://www.uptodate.com/contents/clinical-manifestations-and-diagnosis-of-arthritis-associated-with-inflammatory-bowel-disease-and-other-gastrointestinal-diseases
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