Arthritis

ARTHRITIS/ACHING JOINTS

There is strong evidence that a high percentage of people who suffer from IBD also have aching joints. It is estimated that between 25%-50% of all IBD patients have 'arthralgia', or aching of the joints. While this ailment is the most common form of 'arthritis-like' pain, is not arthritis, (which is clinically described as inflammation of the joints)

However, there are two different types of arthritis associated with IBD.................

PERIPHERAL or COLITIC ARTHRITIS......

Characterized by pain, swelling and stiffness in one or more of the large peripheral joints, usually the arms or legs. Frequently only one or two joints are involved and it may migrate from joint to joint. When untreated, the joints remain painful for several weeks but unlike other forms of arthritis there is generally no permanent damage. Once the inflammation disappears the function of the joint returns to normal. Patients on prednisone find that the immediate relief of joint pain adds to the euphoric feeling of health. This type of arthritis is more common in colitis and its severity usually parallels the degree of inflammation in the colon. Treatment of and improvement of the colitis usually translates into improvement in the arthritis as well. Parients improve on corticosteroids and even on sulfasalazime. Colectomy appears to cure the arthritis associated with ulcerative colitis but this does not seem to be the case for Crohn's. The cause of this form is unknown but it is suggested that some of the inflammation represents an immunologic response to substances that may enter the body through the inflamed bowel wall.

SPONDYLITIS or SPINAL ARTHRITIS......

Joint pain and stiffness in the vertebrae of the spinal column. This disease is genetically linked with an antigen found in the blood (HLA-B27) and is a rare complication of IBD nor is it improved with treatment for the bowel inflammation. Also, unlike peripheral arthritis, spinal arthritis may result in fusion of the bones of the vertebral column, leading to a permanent decrease in the range of moton of the back. The most frequent areas of involvement of the spine involve the sacroiliac joints (lower back). Pain and stiffness are usually worse in the morning on arising and improve with activity. In most cases, active spinal arthritis does not persist beyond the age of forty years. Although bony fusion and permanent disability may occur early in the course of illness.

TREATMENT.....

Usually includes physiotherapy using stretching exercises in addition to moist heat applications. Aspirin and naproxen are usually prescrived for the pain. These drugs relieve the pain but do not alter the course of the disease and may exacerbate the accompanying IBD. Steroids are not recommended because they soften the bones (osteoporosis), and this may be a major, long term problem with thise drugs.

However, with proper treatment most of the symptoms can be controlled and most people remain free from functional disability.

In a Research Diet (Dr. Del.amar Gibbons) noted that...'eliminating all sugars, fructose, sucrose, lactose, and in some cases gluten.....participants experienced a reduction in arthritis symptoms as well as colitis symptoms'.

The herb 'cat's claw, DHEA, (dehydroepiandrosterone) and even enzyme supplements appear to be helpful in relieving pain, swelling and inflammaton. However, cat's claw, and DHEA are just too new on the market for us to get past the accompanying hyperbole that has been generated so far.

Copied from 'The Olde Crohn Speaks'

(no folks, NOT O.C.)

at.

mailto:crohn@squeaky.free.org

Updated July 2003