Enteropathic arthritis

"The goal of treatment is to control the inflammation in order to decrease patients' symptoms and disability, preventing permanent damage to the joints".

DR. Mª JOSÉ CUADRADO LOZANO
DIRECTOR. RHEUMATOLOGY SERVICE

Enteropathic arthritis is a group of inflammatory joint diseases that occur within various intestinal diseases.

Most of these arthritis are associated with

  • Chronic inflammatory bowel diseases: Crohn's disease and ulcerative colitis.
  • Whipple's disease.
  • Arthritis associated with intestinal anastomosis.
  • Arthritis associated with celiac disease.
  • Collagenous arthritis.
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What are the symptoms of enteropathic arthritis?

The most common symptoms are:

  • Alteration in the absorption of food.
  • Diarrhea.
  • Abdominal pain.
  • Articular pain.
  • Inflammation of the joints.

Do you have any of these symptoms?

You may have enteropathic arthritis

Inflammatory Bowel Disease

Crohn's disease and ulcerative colitis are of unknown cause, chronic evolution and variable extension along the digestive tract.

Among its most frequent extra intestinal manifestations are those that affect the locomotive system in the form of inflammation or joint pain.

The existence of genetic factors has been demonstrated, being the HLA B27 the one that is associated with greater risk of affectation of the spine (spondylitis) and the sacroiliac joints (sacroileitis).

The patients can present arthritis of great articulations, of predominance in inferior members (mainly knees and ankles), in form of outbreaks. It is more frequent in patients with severe intestinal disease.

Whipple's disease

Whipple's disease is an infectious disease caused by Tropheryma whipplei.

It is characterized by abdominal pain, diarrhea, fever or fever and weight loss, accompanied by other systemic manifestations (cardiac and neurological involvement) including rheumatology.

In case of articular affectation this one usually takes place in form of arthritis of one or several articulations, episodic, migratory and that is solved, generally, without leaving sequels.

With less frequency also it can be affected the spine (espondilitis) and the articulations sacroilíacas.

How is enteropathic arthritis diagnosed?

First of all, it is necessary to take a detailed clinical history to know well the symptoms presented by the patient.

Later, analytical tests are performed to determine if there are markers of a rheumatic disease. It is necessary to determine if there is positivity for the HLA-B27.

In a negative HLA B27 spondylitis, a careful study has to be made to rule out the existence of an intestinal inflammatory disease.

As extraintestinal manifestations can be observed musculoskeletal symptoms (involvement of peripheral joints, spine or prosthesis), cutaneous-mucosal, ophthalmological, hepatobiliary, hematological and respiratory.

How is enteropathic arthritis treated?

The treatment and monitoring of this disease is carried out in a joint and multidisciplinary way with other services.

Outbreaks of peripheral arthritis are often accompanied by periods of increased activity of the bowel disease and often improve with treatment.

In contrast, spinal involvement is independent of bowel activity. The treatment is symptomatic, with rest and nonsteroidal anti-inflammatory.

In refractory cases, oral corticoids or local infiltrations are used. In the affectation of the column the rehabilitation is very important.

As a background treatment, sulfasalazine is usually used.

The treatment of Whipple's disease is carried out with antibiotics and, in the cases that are needed, with non steroid anti-inflammatory.

Where do we treat it?

IN NAVARRE AND MADRID

OUR MEDICAL TEAM

Rheumatology Service Specialists

The Rheumatology Service has a multidisciplinary team highly specialized in the diagnosis and treatment of rheumatological diseases, from osteoarthritis, arthritis or osteoporosis to autoimmune or inflammatory diseases.

In addition, we have doctors specialized in assisting pregnant women with autoimmune diseases, in order to guarantee the maximum safety of the fetus.

Organized in specialized units

  • Inflammatory arthropathies.
  • Degenerative arthropathies.
  • Microcrystalline arthropathies.
  • Bone pathology.
  • Systemic autoimmune diseases.
  • Autoinflammatory diseases.
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