A recent Mayo Clinic study has concluded that rheumatoid arthritis warrants more attention regarding not just the upper gastrointestinal problems that often plague patients, but also the many lower GI conditions that appear.
These lower GI problems include ulcers, bleeding and perforations, especially in the colon.
Rheumatoid arthritis patients are at greater risk for GI problems and gastrointestinal-related death than people without the disease, stated an April 3, 2012, Mayo Clinic press release. Upper GI problems have actually decreased among RA patients, thanks to greater understanding of the side effects of traditional arthritis medications. But the incidence of lower GI complications is rising, the Mayo says.
The clinic’s research, published in The Journal of Rheumatology, points to smoking, the use of glucocorticoids (steroids), prior upper GI disease and abdominal surgery as being associated with lower GI conditions in RA patients.
The study involved 813 patients with rheumatoid arthritis and 813 without it. For both upper and lower GI problems, those with RA showed a greater incidence than those without RA, although the numbers indicated that there had been a decline over the years in specifically upper GI problems.
Of the arthritis patients studied, however, 229 died, and GI problems were a significant factor, presenting themselves as bleeding, perforations and obstructions.
“Our findings emphasize that physicians and patients must be vigilant for these complications, which can occur without causing abdominal pain," said Dr. Eric Matteson, coauthor of the study and chair of Mayo’s Department of Rheumatology in Rochester, Minn.
“Especially stopping smoking and reducing the use of corticosteroids would appear to be important in reducing the risk of major lower GI complications," he added.
Rheumatoid arthritis is a chronic inflammatory disease of the joints that affects an estimated 1.3 million Americans, according to the Arthritis Foundation.
RA occurs when the body’s immune system mistakenly attacks the membrane lining the joints, resulting in pain and inflammation, joint damage and even disability.