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Enteropathic Arthritis

Enteropathic arthritis involves the peripheral joints, usually in the lower extremities such as the knees or ankles. It commonly involves only a few or a limited number of joints and may closely follow the bowel condition. This occurs in approximately 11 percent of patients with ulcerative colitis and 21 percent of those with Crohn's disease. The synovitis is generally self-limited and non-deforming.

Ankylosing spondylitis is an inflammatory arthropathy of the spine. It occurs in about 7 percent of patients with inflammatory bowel disease. Minimally it involves the sacroiliac joints of the pelvis causing low back or "hip" pain. In some individuals, it may involve the lumbar spine, upper back, and neck. This form seems to follow a course independent of the activity of the bowel disease.

 
 

Reactive arthritis is an acute inflammatory arthritis that follows bacillary (infectious) dysentery. It occurs following a bacterial infection of the small or large colon, but it is not a direct infection of joints. Something occurs in the process of the body protecting itself at the intestine that results in a more distant reaction of inflammation in the peripheral joints. This type of arthritis can linger for weeks or months and then subside. It can also become a recurring type of arthritis called Reiter's syndrome. A fascinating aspect of reactive arthritis is that a cause that "triggers" the process leading to arthritis can be identified.

Bowel bypass arthritis offers similar clues. Intestinal bypass was a technique to control obesity by surgically excluding a section of the small bowel and then connecting the proximal and distal portions of the intestines. The "excluded" portion of the intestine was bypassed by food material but remained in the abdomen. Among several frequent complications, patients developed an enteropathic type of arthritis. It was observed that in patients in which the excluded bowel was surgically reconnected to the intestine, the arthritis resolved.

It has been suspected that the "excluded" portion of the colon allows an overgrowth of intestinal bacteria that triggers different varieties of arthritis. The association with the intestinal tract and the immune system in these disorders may be a clue for future treatment or prevention.

Juvenile Enteropathic Arthritis

Juvenile enteropathic arthritis occurs in combination with inflammatory bowel diseases (IBD) such as Crohn's disease or ulcerative colitis. It also can affect the spine and sacroiliac joints.

Signs and Symptoms

Arthritis in large joints, such as the knees, hips, ankles and elbows, either concurrent to IBD or before IBD show up

IBD, such as Crohn's disease or ulcerative colitis

Eye inflammation

Skin lesions, such as tender bumps on the shins (erythema nodosum) or large, painless leg ulcers (pyoderma gangrenosum)

Bowel Problems
Your doctor will ask many questions about your child's stomach and bowel habits to determine if there are any symptoms of IBD. Sometimes, stomach aches or diarrhea due to side effects from medications can be difficult to differentiate from IBD. It may be necessary for your child to have special tests to evaluate his or her stomach. A pediatric gastroenterologist may be asked to help evaluate your child.

NOTE: Children with IBD might be more sensitive to some medications, making arthritis more difficult to treat. Make sure you discuss these issues with your doctor.

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This web site is intended for your own informational purposes only. No person or entity associated with this web site purports to be engaging in the practice of medicine through this medium. The information you receive is not intended as a substitute for the advice of a physician or other health care professional. If you have an illness or medical problem, contact your health care provider.

Arthritis can develop as a result of an infection. For example, bacteria that cause gonorrhea or Lyme disease can cause arthritis. Infectious arthritis can cause serious damage, but usually clears up completely with antibiotics. Scleroderma is a systemic disease that involves the skin, but may include problems with blood vessels, joints, and internal organs. Fibromyalgia syndrome is soft-tissue rheumatism that doesn't lead to joint deformity, but affects an estimated 5 million Americans, mostly women. The approximate number of cases in the United States of some common forms of arthritis.

Arthritis-Symptom.com is an informational out reach of the Consumer Health Information Network. It is our goal to provide up to date information about arthritis and other inflammatory and bone conditions in a easy to understand format.

Where we get our information.

Most of the information in the site is compiled by editors from information provided by the National Institutes of Health. We are in the process of updating our pages. In the past we have not made reference to the source for information provide by our editors. In the next few weeks we hope to have all our pages marked as to the source.

We have included information from the National Institute of Arthritis and Musculoskeletal and Skin Diseases. Pages that uses information from this source are so acknowledged.

We have contributing authors that send information. Where information is provided by an outside author it is acknowledged by a byline under the title.

Updates of Pages.

Not all of our pages have a date as to the last update. We are in the processes of reviewing all our pages and as we do we include a reference as to when the page was updated. This web site was first published in January of 2003. All pages in the site were created at sometime during or after that time.