Gastrointestinal problems in Fibromyalgia and Rheumatoid Arthritis

By: Dr Alex Robber

You are not alone if you have rheumatoid arthritis (RA) and have digestive problems on top of it. Studies have discovered more gastrointestinal (GI) issues for individuals with RA than for individuals without RA.

Higher rates of inflammation and impaired immunity are likely to play an important role due to the disease. In addition, drugs used to treat rheumatoid arthritis–including non-steroidal anti-inflammatory medicines (NSAIDs), corticosteroids, and therefore most disease-modifying anti-rheumatic drugs (DMARDs)–list GI issues as a prevalent side impact.

Fibromyalgia is another factor. Approximately 20–30% of RA individuals develop fibromyalgia. Therefore Abdominal pain, bloating and alternating constipation and diarrhea (sometimes referred to as irritable bowel syndrome or spastic colon) are among many symptoms of fibro.

A research released in the 2011 Journal of Nutrition discovered that most individuals with RA had GI illnesses such as constipation (66%) or diarrhea (11%), potentially suggesting an imbalance of intestinal organisms.

According to a 2012 study published in the Journal of Rheumatology, in those with RA, the risk of developing an upper or lower GI event was 70% higher than in those without RA – and when these events occurred, they were more likely to be severe and require hospitalization in people with RA.

Therefore Upper GI incidents (which occur between the mouth and the end of the stomach) include bleeding, GI perforation (a hole in the abdomen wall), ulcers, obstruction, and esophagitis (esophagus inflammation, irritation, or swelling). Because Lower-GI incidents (influencing the big and small intestines) include bleeding, perforation, ulcers, obstruction, diverticulitis (infection or inflammation of tiny bags in the intestine lining) and colitis (great intestine swelling).

Upper-GI issues were partially ascribed to the use of NSAIDs in RA patients. However Increased awareness of NSAID’s side effects, their wiser use, and the addition of proton pump inhibitors to regulate upper-GI symptoms helped decrease the incidence of RA-related upper-GI issues. Indeed, the research discovered that the incidence of upper-GI tract issues decreased in individuals with RA over the 28-year study period (although still greater than in the general population). On the other side, during the same time span, the incidence of lower-GI tract issues remained constant.

People with RA had an enhanced risk of infectious colitis (infection-induced inflammation of the colon), drug-induced colitis, lower GI bleeding, perforation, and diverticulitis compared to non-RA patients. The variables found in this research were smoking, corticosteroid use (such as prednisone and cortisone), previous upper-GI disease, and abdominal surgery.

“We still see a rise of about 50% in lower-GI issues in individuals with RA compared to those without it. More attention is required to tackle issues with lower GI, “tells co-author of the study Eric Matteson, MD, chair of rheumatology at the Mayo Clinic in Rochester, Minn. Better strategies and therapy methods are required to tackle lower-GI issues in individuals with RA, such as timely therapy of upper-GI disease, minimizing corticosteroid exposure, avoiding smoking, and lower-GI disease screening, all of which can assist decrease the incidence or severity of lower-GI issues. Stay Healthizes!

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