Inflammatory Bowel Disease Specialist

What is inflammatory bowel disease?

Inflammatory bowel disease (IBD) refers to two conditions: ulcerative colitis and Crohn's disease. These are both gastrointestinal system disorders, with Crohn's disease potentially affecting any part of your digestive tract while ulcerative colitis occurs in the large bowel (colon) and rectum.

IBD symptoms commonly include:

• Cramping abdominal pain
• Diarrhea
• Rectal bleeding
• Mucus, blood, or pus in the stool
• Fecal incontinence
• Weight loss
• Chronic fatigue
• Loss of appetite
• Recurring fever

Crohn's disease can also cause fistulas, painful channels between the bowel and other organs. Some people with IBD develop joint pain as well, specifically axial and peripheral arthritis.

How does arthritis affect people with inflammatory bowel disease?

Peripheral arthritis most commonly affects people with ulcerative colitis or Crohn's disease of the colon. Symptoms of peripheral arthritis include joint pain, swelling, and stiffness in one or more joints, most often the knees, ankles, elbows, and wrists.

Peripheral arthritis pain can last for several days or weeks at a time before receding. The changes tend to go in cycles, so you could have a long period of remission in between bouts of more severe pain. Peripheral arthritis doesn't usually cause permanent damage to your joints.

Axial arthritis (spondyloarthropathy) often appears months or even years before IBD symptoms. It causes pain and stiffness in the facet joints that connect the vertebrae in your spine. These symptoms are typically more severe in the morning, then improve with physical activity.

Axial arthritis can sometimes result in fusion of the vertebrae, restricting your spinal flexibility and potentially limiting your ability to breathe deeply. 

Active axial arthritis usually appears in younger patients and typically becomes inactive past the age of 40. A similar condition, ankylosing spondylitis, affects a small proportion of patients with IBD.

How is inflammatory bowel disease-related arthritis treated?

One of the challenges of treating inflammatory bowel disease-related arthritis is that one of the primary forms of pain relief for other forms of arthritis – nonsteroidal anti-inflammatory drugs or NSAIDs – can make IBD worse.

Your provider at Arthritis Associates is likely to recommend resting the painful joints, using splints, occasionally applying moist heat, and following a physical therapy program. Postural and stretching exercises to keep your spine mobile are particularly important if you have axial arthritis.

Managing the IBD to reduce inflammation is vital for treating peripheral arthritis. Some of the IBD medications that may also ease symptoms of peripheral arthritis include:

• Prednisone
• Anti-tumor necrosis factor-alpha (anti-TNF) drugs
• 5-aminosalicylates such as sulfasalazine
• Methotrexate

While these medications are less effective in directly relieving symptoms of axial arthritis, they may still be beneficial.

If you have inflammatory bowel disease and suffer from joint pain, get expert help by calling Arthritis Associates or booking an appointment online today.