Arthritis with Inflammatory Bowel Disease

Question 1

What percentage of patients with IBD have arthritis?

Answer 1

Arthritis occurs in about 25% of patients with inflammatory bowel disease.

Question 2

What are the (13) systemic signs/symptoms of arthritis with IBD?

Answer 2

Fatigue, iron deficiency anemia, low albumin, persistently elevated inflammatory markers, weight loss, growth delay, fever, oral ulcers, abdominal pain/tenderness, diarrhea, erythema nodosum, polyderma gangrenosum, and clubbing.

Question 3

What are the characteristics of peripheral arthritis in patients with IBD?

Answer 3

It is the more common of the two types of IBD-associated arthritis. Incidence is equal in males and females, it is not associated with HLA-B27, and arthritis flares occur at the same time as gut flares.

Question 4

What are the characteristics of axial arthritis in patients with IBD?

Answer 4

It is the less common of the two types of IBD-associated arthritis. Incidence in males is significantly higher than in females, it is associated with HLA-B27, and arthritis occurs independently of gut flares.

Question 5

Describe the efficacy of oral DMARDs in treatment of spinal vs peripheral arthritis w/ IBD.

Answer 5

Oral DMARDs do not help with spinal disease, only peripheral disease.

Question 6

What is the role of NSAIDs in treatment of arthritis with IBD?

Answer 6

NSAIDs are used sparingly because of risk for IBD flares and GI side effects.

Question 7

What is the typical treatment for arthritis coinciding with a gut flare in IBD?

Answer 7

The arthritis usually responds to appropriate therapy for the gut disease, such as corticosteroids or oral DMARDs.