The Link Between IBD and Early-Onset Arthritis

About one in five people with inflammatory intestine disease (MII), including Crohn’s disease and ulcerative colitis, also experiences joint pain. Enteropathic arthritis (ENA) is a chronic type (long -term) of inflammatory arthritis that can develop in people with MII, affecting joints in the arms and legs or spine and lower back. Symptoms of arthritis such as pain and stiffness tend to worsen during MII thrusts.

The exact cause of arthritis linked to the MII is not fully understood. However, research suggests that several factors probably play a role, including:

• A hyperactive immune system: MIIs occur when the body’s immune system mistakenly attacks the digestive tract, which includes the mouth, throat, esophagus (the tube connecting the throat to the stomach), the stomach, the small and the large intestine, the rectum (the end of the serious intestine) and the anus. This hyperactive immune response can cause inflammation and mistakenly attack joint tissues, resulting in pain, swelling and stiffness.
• Distribution of the intestinal barrier: When the MII ignites and damages the intestinal lining, it can create a fleeing intestine, allowing bacteria and other harmful substances to escape in the blood circulation. The immune system reacts to these substances, which can trigger joint inflammation.
• Dysbiosis (imbalance in intestinal bacteria): This condition occurs when the balance of useful and harmful bacteria in your intestine is disturbed. In people with MII, this imbalance can affect the functioning of the immune system, leading to inflammation which can spread beyond the intestine and affect the joints.
• Chronic inflammation: Inflammation in progress in the digestive tract can cause inflammation to the body (systemic) which can affect joints and cause arthritis.
• Infection: Bacterial and parasitic infections can trigger inflammation and contribute to the development of arthritis in some people with MII.
• Genetic: Some people inherit genes (features transmitted by families) which increase their risk of MII and arthritis. For example, around 60% of people with arthritis linked to the MII bear the HLA-B27 gene, which is a gene which is generally linked to inflammatory conditions.
• Smoking: Smoking can worsen intestinal inflammation, interfere with healing and can increase the risk of developing arthritis in people with MII.

Enteropathic arthritis can affect the joints of the body, most often involving joints in the lower limbs, such as knees and ankles. However, this can also affect elbows, wrists, shoulders and, in some cases, hips or spine.

Peripheral arthritis (in arms and legs) often rushes alongside the symptoms of MIIs like diarrhea and abdominal pain. Inflammation in the spine and back pain is not also likely to occur with Mii eruptions.

Symptoms of Enteropathic arthritis can range from slight discomfort to more serious joint pain, which can do activities such as walking, dressing or more difficult work. Enteropathic arthritis symptoms may include:

• Joint pain and stiffness, especially in the knees, ankles, wrists or fingers
• Joint pain that evade during the escapes of the MII, although it can also happen by itself
• Swollen joints that may feel warm or tender
• Stiff joints in the morning that improve with the movement
• Lower back or stiffness, especially in the Sacro -liac joints (where the spine meets the basin)
• Fatigue or low energy, even after rest
• Eye inflammation (uveitis), which can cause changes in redness, pain or vision
• Skin rashes

Everyone with MII will develop enteropathic arthritis. However, several factors may increase your risk:

• MII type and severity: People with Crohn’s disease have a higher risk of developing arthritis than those with ulcerative colitis. Articular pain and swelling are also more likely from those who have more serious or frequent Mii thrusts.
• Family history: If you have parents with MIIs or inflammatory arthritis, you can transport genes that increase your risk.
• Age: Enteropathic arthritis can occur at any age, but symptoms generally start between 15 and 40 years.
• Other autoimmune conditions: Have another autoimmune condition, such as psoriasis or Ankylosing spondylitiscan increase your risk of developing arthritis associated with MII.
• Smoking: Tobacco consumption can trigger or worsen the symptoms of IBD and can cause inflammation throughout your body, increasing the risk of arthritis.

If you have MIIs and start to feel joint pain, stiffness or swelling, it is important to speak with a doctor. They will start by examining your medical and family history, as well as your current symptoms, then carry out a physical exam to assess the sensitivity, swelling and amplitude of movements.

Your doctor can order diagnostic tests for a more precise diagnosis and recommend a treatment plan. These tests may include:

• Soultry test (poop): Your doctor can order a sample of stools to exclude infections and confirm a diagnosis of MII.
• Coloscopy: This test is to insert a long flexible tube (coloscope) in your anus and your rectum to examine the interior of your colon (large intestine) and rectum. They can also take a biopsy (a small sample of fabric) to give you an appropriate diagnosis.
• Blood tests: These types of blood tests, such as reactive C protein (CRP) and Erythrocyte sedimentation rate (Esr) tests, check the signs of inflammation in the blood.
• Genetic test: These are blood tests that can check the specific genes that increase your risk of developing arthritis linked to MII.
• Articular fluid analysis: Your doctor can draw a small sample of synovial liquid From a swollen joint to help exclude conditions such as gout or joint infections. The synovial fluid is the liquid found between the joints which helps the joints to move easily.
• X -rays: These are imaging analyzes that can show signs of joint lesions or inflammation, in particular in the spine or the largest joints, such as hips.

The treatment of MII and Enteropathic arthritis focuses on reducing inflammation to relieve symptoms and protect your joints and your digestive tract. Your doctor will work with you to create a personalized treatment plan that may include:

• Anti-inflammatory drugs: Non-steroidal anti-inflammatory drugs (NSAIDs) and corticosteroids can help alleviate joint pain and swelling.
• Anti -utilatic drugs modifying the disease (Dmards): These drugs help regulate the immune system to reduce inflammation and slow down the progression of the disease. They can slow down or prevent joint lesions and help control the symptoms of MICI.
• Physical therapy: A physiotherapist can teach you stretching and exercises to maintain the flexibility and the strength of your joints. They will also teach appropriate posture and body mechanics (how to move and position your body) during daily activities to reduce pain and protect your joints.
• Heat and cold therapy: The application of heat, such as a hot compress or a heating cushion, can loosen the steep joints and facilitate pain. Cold therapy, such as ice packs, can help reduce swelling and inflammation during a push.
• Regular exercise: Low impact activities such as walking, cycling, swimming or yoga can improve joint mobility (movement) and reduce inflammation. If you are new in exercise or you feel pain, start slowly and take breaks if necessary.
• Stress management: Stress can trigger or worsen the symptoms of MII and arthritis. Relaxation techniques such as mindfulness meditation, deep breathing or progressive muscle relaxation can help reduce the frequency and severity of the eruptions of symptoms.
• A balanced diet: A nutritious and balanced diet that includes anti-inflammatory foods, such as leafy green vegetables, berries, fatty fish and whole grains, can help fight inflammation. Try to avoid or limit the consumption of triggers of mii currents or foods which can cause inflammation, such as processed foods, added sugars and meals rich in fat or spicy.

Many people with inflammatory intestine disease (MII) also experience joint pain. Indeed, the same inflammation which affects the digestive tract in the MII can also affect the joints, causing pain, stiffness and swelling.

MII arthritis, known as enteropathic arthritis, often vanishes or worsens when the symptoms of the MII. The management of the two conditions can be overwhelming and can affect your emotional well-being, your energy level and your daily routine. With the right processing plan and support of support life, you can relieve symptoms and continue to do things that matter most for you.