Treatment of Arthritis with Ulcerative Colitis

Abstract

Arthritis, or joint inflammation, is the mostcommon complication of ulcerative colitis. Twenty-five percent of people withulcerative colitis suffer from it, and it is often found in young patients. Inaddition to joint pain, arthritis also causes swelling and stiffness (stiffnessin the joint). With ulcerative colitis, arthritis can manifest itself in twodifferent forms: Peripheral arthritis usually affects large joints of the handsand feet, including elbows, wrists, knees and ankles. Pain can"migrate" from one joint to another and last from a few days toseveral weeks. The more intense the inflammatory process in the colon, the morepronounced arthritis. To date, there are no special tests to confirm ulcerativecolitis-associated arthritis. This diagnosis can be made only by eliminatingother causes of pain in the joints. Fortunately, such peripheral arthritisusually does not cause a significant change in the function of the joint.Spondyloarthritis (arthritis of the intervertebral joints) causes pain andstiffness in the lower part of the spine and sacroiliac joints. In youngpeople, these symptoms may appear much earlier than intestinal manifestations.Unlike peripheral arthritis, spondyloarthritis can lead to a significantdeterioration in the function of the spine, as the amount of movement in theintervertebral joints decreases. Spondylitis usually appears at the age ofabout 35-45 years. In most cases, the symptoms of peripheral arthritis decreasewith the disappearance of inflammation in the large intestine. After a courseof drugs such as prednisolone or sulfasalazine, joint pain usually disappears.The use of Infliximab (Remicade ®) for the treatment effectively reducesinflammation and swelling of the joints. Unlike peripheral arthritis,unfortunately, in spondyloarthritis there is no such clear relationship betweenthe disappearance of signs of inflammation in the intestine and thedisappearance of joint symptoms. In such patients, non-steroidalanti-inflammatory drugs (NSAIDs) are used to relieve pain and swelling of thejoints. However, these drugs should be used under the supervision of a doctor,as they can provoke an exacerbation, since they irritate the intestinal mucosa.To prevent a decrease in the volume of movement in the joints it is veryimportant to engage in exercise therapy.