Treatment of Arthritis with Ulcerative Colitis

Abstract

Arthritis, or joint inflammation, is the most common complication of ulcerative colitis. Twenty-five percent of people with ulcerative colitis suffer from it, and it is often found in young patients. In addition to joint pain, arthritis also causes swelling and stiffness (stiffness in the joint). With ulcerative colitis, arthritis can manifest itself in two different forms: Peripheral arthritis usually affects large joints of the hands and feet, including elbows, wrists, knees and ankles. Pain can "migrate" from one joint to another and last from a few days to several weeks. The more intense the inflammatory process in the colon, the more pronounced arthritis. To date, there are no special tests to confirm ulcerative colitis-associated arthritis. This diagnosis can be made only by eliminating other causes of pain in the joints. Fortunately, such peripheral arthritis usually does not cause a significant change in the function of the joint. Spondyloarthritis (arthritis of the intervertebral joints) causes pain and stiffness in the lower part of the spine and sacroiliac joints. In young people, these symptoms may appear much earlier than intestinal manifestations. Unlike peripheral arthritis, spondyloarthritis can lead to a significant deterioration in the function of the spine, as the amount of movement in the intervertebral joints decreases. Spondylitis usually appears at the age of about 35-45 years. In most cases, the symptoms of peripheral arthritis decrease with the disappearance of inflammation in the large intestine. After a course of drugs such as prednisolone or sulfasalazine, joint pain usually disappears. The use of Infliximab (Remicade ®) for the treatment effectively reduces inflammation and swelling of the joints. Unlike peripheral arthritis, unfortunately, in spondyloarthritis there is no such clear relationship between the disappearance of signs of inflammation in the intestine and the disappearance of joint symptoms. In such patients, non-steroidal anti-inflammatory drugs (NSAIDs) are used to relieve pain and swelling of the joints. 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 very important to engage in exercise therapy.

Keywords

• Arthritis,Ulcerative colitis,Treatment

References

1. Brodszky V., Baji P., Balogh O., Péntek M. (2014). Budget impact analysis of biosimilar infliximab (CT-P13) for the treatment of rheumatoid arthritis in six Central and Eastern European countries. Eur. J. Health Econ. 15(Suppl. 1), S65–S71. 10.1007/s10198-014-0595-3 [PMC free article][PubMed] [Cross Ref] Cooksey R., Husain M. J., Brophy S., Davies H., Rahman M. A., Atkinson M. D., et al. . (2015). The cost of Ankylosing Spondylitis in the UK using linked routine and patient-reported survey data. PLoS ONE 10:e0126105. 10.1371/journal.pone.0126105 [PMC free article] [PubMed] [Cross Ref] Danese S., Gomollon F. (2013). Governing board and operational board of ECCO. ECCO position statement: the use of biosimilar medicines in the treatment of inflammatory bowel disease (IBD). J. Crohns. Colitis 7, 586–589. 10.1016/j.crohns.2013.03.011 [PubMed] [Cross Ref] Dignass A., Lindsay J. O., Sturm A., Windsor A., Colombel J. F., Allez M., et al. . (2012). Second European evidence-based consensus on the diagnosis and management of ulcerative colitis part 2: current management. J. Crohns. Colitis 6, 991–1030. 10.1016/j.crohns.2012.09.002 [PubMed][Cross Ref] Dörner T., Kay J. (2015). Biosimilars in rheumatology: current perspectives and lessons learnt. Nat. Rev. Rheumatol. 11, 713–724. 10.1038/nrrheum.2015.110 [PubMed] [Cross Ref] Fautrel B., Woronoff-Lemsi M. C., Ethgen M., Fein E., Monnet P., Sibilia J., et al. . (2005). Impact of medical practices on the costs of management of rheumatoid arthritis by anti-TNFα biological therapy in France. Joint Bone Spine 72, 550–556. 10.1016/j.jbspin.2004.12.009 [PubMed][Cross Ref]