People with Rheumatoid Arthritis at Risk of Gastrointestinal Problems
People with rheumatoid arthritis (RA) are more likely than people without the condition to experience gastrointestinal problems such as ulcers, bleeding, and perforations (holes in the wall of the gastrointestinal tract). These results were published in The Journal of Rheumatology.
Rheumatoid arthritis (RA) affects an estimated 1.3 million adults in theUnited States. The symptoms of RA are familiar to many: the condition causes pain, swelling, and stiffness of joints. The joints of the wrist and hand are often involved, but RA can affect other joints as well. Joint stiffness tends to be worse in the morning or after a long rest.
RA and RA treatments can also affect other parts of the body. To explore the frequency of problems involving the upper and lower gastrointestinal tract, researchers at the Mayo Clinic conducted a study among 813 people with RA and 813 people without RA. The upper gastrointestinal tract includes the esophagus, the stomach, and the first part of the small intestine. The lower gastrointestinal tract consists of the rest of the small intestine and the large intestine.
Study participants were followed for over 10 years. Information was collected about GI problems such as ulcers, bleeding, obstructions, and perforations.
- The frequency of upper GI problems in people with RA declined over time, but remained higher than the frequency in people without RA. Upper GI problems occurred in 2.9 per hundred people per year in people with RA, and 1.7 per hundred people per year in people without RA.
- The frequency of lower GI problems in people with RA did not decrease over time. Lower GI problems occurred in 2.1 per hundred people per year in people with RA, and 1.4 per hundred people per year in people without RA.
- Factors that increased the likelihood of lower GI problems in people with RA were smoking, use of glucocorticoids (a type of steroid), prior upper GI disease, and abdominal surgery.
- People with RA who experienced an upper or lower GI problem were at increased risk of death.
Previous studies have reported on the increased risk of upper GI problems in people with RA, and these problems appear to be on the decline. The recognition that lower GI problems are also an issue may encourage new approaches to the prevention and treatment of these problems. Smoking cessation and reduction in use of glucocorticoids, for example, may reduce the risk of lower GI problems in people with RA.
Reference: Myasoedova E, Matteson EL, TalleyNJ, Crowson CS. Increased incidence and impact of upper and lower gastrointestinal events in patients with rheumatoid arthritis in Olmsted County, Minnesota: a longitudinal population-based study. The Journal of Rheumatology. Early online publication April 1, 2012.