Arthritis associated with inflammatory bowel disease
Joint manifestations associated with inflammatory bowel disease. Follow-up may require collaboration between a rheumatologist and gastroenterologist.
About the condition
Joint manifestations associated with inflammatory bowel disease. Follow-up may require collaboration between a rheumatologist and gastroenterologist.
Associated with Crohn disease or ulcerative colitis. Peripheral and axial inflammation may relate differently to bowel disease activity.
Symptoms
Peripheral arthritis, back pain and enthesitis may occur. Joint symptoms do not always coincide with a bowel disease flare.
Joint pain and swelling may coexist with enthesitis or inflammatory back pain. Bowel symptoms may precede or follow arthritis.
Diagnosis
A rheumatologist and gastroenterologist jointly assess joint and bowel manifestations. MRI, ultrasound and laboratory tests are selected for the clinical question.
Rheumatology and gastroenterology combine joint findings, endoscopy and tests. Distinguish inflammation from medication-related or mechanical pain.
Treatment
Treatment considers both bowel and joint disease. NSAIDs and immune therapies are coordinated with clinicians; not all agents are appropriate in IBD.
Where possible, choose treatment effective for both conditions. NSAIDs require caution; some arthritis therapies can worsen IBD.
Monitoring
Bowel symptoms, joint activity, nutrition and treatment safety are monitored. New blood in the stool or marked deterioration needs medical assessment.
Track bowel habit, blood in stool, weight and joint function. Bleeding, dehydration or severe abdominal pain need prompt assessment.
Sources
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