Gastrointestinal Complications in Rheumatoid Arthritis - An Insight

How Does Rheumatoid Arthritis Affect the GI System?

The gastrointestinal system and rheumatoid arthritis are closely related in numerous ways. According to some studies, complicated interplay, including genetics, environment, and gut microbiota, may cause rheumatoid arthritis. This indicates that illness arises when the immune system, responsible for defending the body against pathogens, inadvertently targets healthy cells. Inflammation of the joints is the main sign of rheumatoid arthritis. But practically every organ in the body, including the gastrointestinal system, can be impacted by rheumatoid arthritis. The Arthritis Foundation estimates that the risk of gastrointestinal issues is almost 70 percent higher in rheumatoid arthritis patients than in non-rheumatoid arthritis patients.

How does RA Lead to Gastrointestinal Symptoms?

A multitude of circumstances may lead to this, including:

• Side Effects of RA Medication - Constipation, discomfort, diarrhea, and bloating are all possible adverse effects of RA treatments. Some medications include nonsteroidal anti-inflammatory drugs (NSAIDs), corticosteroids, and disease-modifying antirheumatic drugs (DMARDs).

• Infection: The body's capacity to fight off infections may be diminished by DMARD use. The gastrointestinal tract may develop diverticulitis or infectious colitis (an infection or inflammation in one or more of the digestive tract's tiny pouches) as a result.

• Other Autoimmune Diseases: Individuals with RA have an increased risk of developing certain autoimmune disorders that can lead to gastrointestinal complications. Celiac disease (it is an autoimmune disease brought on by consuming gluten), autoimmune hepatitis (when the body’s immune system attacks liver cells, which results in inflammation of the liver), and inflammatory bowel disease (IBD) are a few examples.

• RA Can Directly Lead to Other Disorders - Such as Felty's syndrome, which can affect the liver and create gastrointestinal issues once it has taken place in a person's body. The American Foundation (AF) estimates that 5 percent of people with RA will get rheumatoid vasculitis (RV), a condition that causes gastrointestinal tract inflammation.

• Inflammation - Gastrointestinal disorders, such as inflammatory bowel syndrome (IBS), which may be linked to digestive tract inflammation, are prevalent in cases of inflammatory arthritis. The inflammatory process that affects the joints can also impact the digestive tract.

• Gut Bacteria - Stool bacteria in the gastrointestinal tract have been linked to rheumatic illnesses. The gut may include imbalanced bacterial colonies known as gut dysbiosis, closely associated with inflammatory illnesses such as RA and the usual innocuous bacteria found in the gastrointestinal tract. There are several gastrointestinal issues and events linked to gut dysbiosis.

• Coexisting Condition - gastrointestinal tract disorders include celiac disease, a condition where the immune system overreacts to gluten, and IBS, which are among the illnesses that are linked to RA.

What Are the Gastrointestinal Symptoms That Occur as a Direct Result of RA?

RA has been shown to have a variety of effects on the gastrointestinal system.

Felty's Syndrome - Felty's syndrome can occur in uncommon instances of RA.

Several abnormalities of the liver are caused by this illness, including:

• Swelling or enlargement of the veins.

• Enlarged liver varices.

• Accumulation of fluid in the belly.

Rota Virus - In rare situations, people with RA develop rotavirus. About 5 percent of RA patients may experience this. The rotavirus leads to constriction and inflammation of the blood vessels. It can produce inflammation in the gastrointestinal system in addition to its usual effects on the nerves, skin, fingers, and toes.

These are a few rotavirus gastrointestinal symptoms:

• Loss of appetite.

• Weight loss.

• Stomach discomfort.

• Intestinal perforation.

• Diarrhea.

• Stomach ulcers and esophageal ulcers.

Other signs and symptoms include

• Tingling and discomfort in the fingers and toes.

• Rashes, especially on the legs.

• Weakness of the muscles

• Chest ache.

• Fever.

Specific autoimmune diseases that might lead to gastrointestinal issues are more common in people with RA. These prerequisites consist of:

1. Hepatitis Caused by Antibodies

The following are some symptoms of autoimmune hepatitis:

• Exhaustion.

• Nausea.

• Vomiting.

• Weight loss.

• Stomach pain.

• Pale stools.

• Black urine.

• Rashes.

• Arthritic pain.

• Amenorrhoea, or not getting a period.

2. Irritable Bowel Syndrome (IBS)

Signs and symptoms of IBS are as follows:

• Bleeding.

• Recurrent diarrhea.

• Weight loss.

• Cramping and discomfort in the abdomen.

3. Celiac Disease

Several symptoms of celiac disease might appear, such as:

• Constipation.

• Indigestion.

• Bloating.

• Abdominal pain.

4. Sjögren's Disease

Rheumatic disorders like RA coexist with secondary Sjögren's illness. A secondary Sjögren's illness can strike up to 31 percent of RA patients. Those who have RA will experience oral symptoms. It may result in a dry mouth, making swallowing or chewing difficult. The two salivary glands just in front of the ears that secrete saliva to aid in chewing and digestion are also enlarged.

How to Prevent Gastrointestinal Symptoms in Patients With RA?

Many gastrointestinal symptoms that are associated with RA are brought on by a complex combination of biological and environmental factors. Certain gastrointestinal issues may not be preventable. Their diet, though, can lessen some of the symptoms of RA. Another option for preventing some of the negative effects of RA treatment is for people to consider taking folic acid. It may be advised by certain medical practitioners to take one milligram (mg) of folic acid daily. Some advise ingesting a dose of 5 mg of folic acid every week.

Conclusion

Some people with rheumatoid arthritis also develop other autoimmune disorders, though this is not frequent. Among these are disorders characterized by chronic inflammation of the intestines, collectively known as inflammatory bowel disease (IBD). Two of the most frequent kinds of colitis are ulcerative colitis and Crohn's disease. One's likelihood of developing IBD is sometimes increased by having rheumatoid arthritis. Inflammatory bowel disease can produce diarrhea, cramps, bleeding, and weight loss. Gastrointestinal problems may accompany rheumatoid arthritis, even in those who do not. The following are possible issues: ulcers, bleeding, and esophagitis. Reduced use of non-steroidal anti-inflammatory drugs (NSAIDs), switching to COX-2 selective inhibitors, quitting smoking, and limiting the use of glucocorticoids or corticosteroids are ways to reduce the risk of these problems.