You Might Be Unaware How Joint Issues Related To Crohn’S Disease And Ulcerative Colitis

Crohn’s disease and ulcerative colitis (both inflammatory bowel diseases), by definition, primarily affect the gastrointestinal tract. But the immune system dysfunction that drives disease activity occasionally affects other tissues and organs outside the digestive tract. These “extraintestinal manifestations” may take any number of forms. However, the majority affect the skin, eyes, or joints.

Extraintestinal manifestations of the joints may reflect ongoing disease activity in the intestines, or they may occur during times of disease remission. Occasionally, an EIM may occur before a diagnosis of Crohn’s disease or ulcerative Colitis has been obtained. Some manifestations reflect underlying immune system dysfunction, while others may actually represent side effects of drug therapy for the disease, or occasionally, nutritional deficiencies related to poor digestive function. continuer read below

Extraintestinal Manifestations of the Joints

To distinguish among other types of arthritis, such as osteoarthritis or rheumatoid arthritis, where there may be tissue destruction due to inflammation, experts usually refer to Crohn’S Disease- and Ulcerative Colitis-related joint manifestations as arthropathies, rather than arthritis.

Enteropathic Peripheral Arthropathy

Enteropathic peripheral arthropathy is a form of chronic inflammation of the peripheral joints; meaning the joints of the hands, feet, elbows, knees, hips, wrists, etc. (as opposed to the axial joints, which comprise the spine and ribs). The symptoms, which may include red, hot, painful, swollen joints, may resemble common osteoarthritis. Osteoarthritis is thought to be a disease of gradual “wear and tear” of the joints. By definition, though, enteropathic arthropathy differs in that it is related to underlying immune system dysfunction that’s centered in the digestive tract.

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You Might Be Unaware How Joint Issues Related To Crohn’S Disease And Ulcerative Colitis

According to one recent estimate, between 17% and 39% of Crohn’s disease and ulcerative colitis patients will experience some symptoms of enteropathic arthropathy at some time during the course of their disease.* Although enteropathic arthropathy is classified as “chronic,” symptoms may come and go unpredictably. Doctors further subdivide extraintestinal manifestations of the peripheral joints into Type 1 and Type 2.

Type 1 (pauciarticular) tends to be more acute; symptoms last less than 10 weeks; usually reflects ongoing bowel disease activity; fewer than five joints are involved; is more likely to be associated with other extraintestinal manifestations, such as the skin condition, erythema nodosum, or the eye disorder, uveitis.

Type 2 (polyarticular) involves five or more joints; may last months to years; flare-ups don’t necessarily reflect ongoing bowel disease activity; among the other possible manifestations, only uveitis has been associated with Type 2 peripheral arthropathy; is estimated to affect 3% to 4% of patients. continuer read below 

Enteropathic Spondyloarthritis

To make things a little more confusing, though, doctors sometimes call certain manifestations spondyloarthritis. Spondyloarthritis is considered a rheumatic disease. This means an underlying component of the disease reflects immune system dysfunction. Ankylosing spondylitis, for example, occurs when the joints of the spine become inflamed, causing considerable pain and discomfort. In some instances, there may be new, inappropriate outgrowth of bone from individual vertebrae, causing the vertebrae to fuse together. This makes the spine rigid and immobile, and may result in a noticeable forward-stooped posture.

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It should be noted that most people who develop ankylosing spondylitis possess certain genes that predispose them to this condition. For example, up to 95% of Caucasians with ankylosing spondylosis possess a gene for a protein called HLA-B27. But up to 30 different genes may be involved. Ankylosing spondylitis is estimated to affect about 5% patients of Crohn’S Disease and colitis.

Miscellaneous Musculoskeletal Manifestations

Inflammation in the joints is one of the most common extraintestinal manifestations of Crohn’s disease and ulcerative colitis. Although it may resemble ordinary osteoarthritis, Crohn’s Disease- and Ulcerative Colitis-related joint problems tend to reflect underlying bowel disease activity. Fortunately, mounting evidence suggests that treatment with modern biologic drugs is often effective at controlling these symptoms and preventing their progression. Source