Reactive Arthritis, Antibiotics, and Infections

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EveSasser
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Date Joined Mar 2006
Total Posts : 808
   Posted 1/21/2007 11:00 AM (GMT -7)   
Reactive arthritis is triggered by an infection. If you have an active infection, you have to get rid of it, but most reseachers don't believe that you can benefit from antibiotics after the infection is gone. Old doc believed that sub clinical or micro infections could continue to trigger the arthritis and needed to be eradicated to keep from tiggering the arthritis needlessly. For instance, I have been exposed to mycoplasma but have no idea if I have an active infection. New doc has no interest in the topic and believes it is bunk. Right now, I need the new doc to help me get on my feet and do the conventional things - prescribe Enbrel, send me to have an MRI of the lumbar spine, and refer me to physical therapy. However, I may pursue the antibiotic protocol later on. I was in touch with someone from The Road Back who sent me names of some docs that prescribe antibiotics for those with ReA.  Has anyone had experience with this protocol over a period of time and did it make a difference?  I have been on antibiotics for nine months, and I always have some kind of infection, so I am not a good case study. Also, the new doc said I have to find someone to manage my infections because he doesn't want to do that. Old doc did perform this service. I have chronic bladder and sinus infections, and I have to go on antibiotics at the first sign of trouble because I am taking Enbrel. Does anyone else have a similar problem and, if so, what kind of doctor are you seeing to manage your infections? Any advice would be very helpful.

Marius123
Regular Member


Date Joined Aug 2006
Total Posts : 142
   Posted 1/21/2007 2:02 PM (GMT -7)   
 You point to very important question.
Reactie arthritis. What is reactive arthritis? Most of the rheumatologist put diagnosis of reactive arthritis (ReA) when 5 condition are present.
1. 100% proven presence of current infection that has naver been present before, so to consider unambiguous that this infection is the only and sure causative for the reactive arthritis. Of course there are different types of bacteria that are listed to cause reactive arthritis, but this list is a floating list, and not strict. But keep in mind that there is evidence that viruses may also cause reactive arthritis, so the antibiotic 'thing' (which acts only on bacteria), is realy not important here.
2. Presence of symptoms and pathology that fits in the seronegative spondiloarthropaties group (reactive arthritis is a part of the seronegative spondiloarthropaties group). Mostly tendons and ligaments affected, very mild if any synovitis, and migratory pattern.
3. Strongly negative rheumatic diseases antibodies tests (-ANA,-RF...and etc)  (reactive arthritis is a part of the seronegative spondiloarthropaties group, that mean these test are negative) (Otherwise they should put dx RA, or SLE..or etc.)
4. Absense of psoriasis and inflamatory bowel disease (otherwise thay should put dx psoriatic arthritis (PsA) or arthritis associated with IBD).
5. Mild spine and sacroliac joints envolvement (otherwise they should put directly dx: Ankylosing Spondilitis - AS, which is actually a type of reactive arthritis to a gut bacteria)
 
When 2,3, 4  and 5 are only present  (without 1) some docs says that it is reactive arthritis with unknown causative infection, but most of the doctors puts temporary diagnosis of undiferentiated arthritis (so they just have no idea what's wrong with you, but ashame to tell you) and puts you on NSAIDs, may be on wide spectrum abx for week or two, and then starts to 'wait for development'. Actually they do the same if they found you have reactive arthritis too. Abx are tought to do their job for 2 may be 3 weeks not longer. And actually this statement has much accuracy in it because as much abx you take the most resistent the bactaria becomes, and that's how the chronic infections heppens. Bacteria of any types are present in the human body and they live in symbiosis with us. All these types of bacteria is IMPOSSIBLE to be eradicated, so we are talking only about balance, the bacteria usually live in our GI tract (mouth, guts) and genitals, eyes. Our saliva, mucus, tears and our antibodies and pH found on these surfaces doesn't allow the bacteria to grow enough to cause us infection symptoms (so we live as healty). And when some bacteria somehow succeed to grow enough to cause infection (like in your case the sinus infection), then local symptoms on the affected tissue usually appears. Ex. cough is a symptom of bacterial pneumonia (not only)...and etc. Then the abx comes to help. It does not eradicate bacteria but inhibits it's multiplication in order the immune system can cope with the crisis situation. The prolonged use of antibiotics first: disturbes the natural balance bacause it takes the work of the body itself to manage it, and second makes tha bacteria more resistent, but does not eradicate it comletely. It is not recommended to take abx for very long period unless it is proven effective, thats why some doctors, knowing these facts, refuse to treat patients with abx for chronic infections, but exactly the opposite, they try to manage the infection naturaly, to recover the natural balance (I'm talking about non immune-suppressed people, people not taking immune supressing medications) And finally...: if the ReA is caused by a virus, abx does not act on the viruses, and smth more they act weakening on the immune system, and immune system is the only unit that can cope with a virus infection, so.o.o you must take care for it to be strong as possible. So the things are not such simple: got bacteria, take abx untill the bacteria die, and you become sterilized and healty again, because you  will  never become sterilized, as long as there is life on earth.


Official dx, but I have doubts: chronic reiter's syndrome (1yr and 6 mnths).
suffer form occasional conjuctivitis outbreaks, mild arthritis, also showing some short lived mild aches all over the body

Post Edited (Marius123) : 1/21/2007 3:28:37 PM (GMT-7)


EveSasser
Veteran Member


Date Joined Mar 2006
Total Posts : 808
   Posted 1/21/2007 6:27 PM (GMT -7)   
Thank you, Marius -

That was a good summary. I actually have severe spinal involvement to meet the diagnostic criteria of AS, but doc says I don't have AS. It is helpful in that it allows the doc to secure approval for my medication under an approved use.

Unfortunately, I have to take antibiotics because I am on Enbrel, an immuno suppressant. I dislike that I have to take Enbrel but I cannot walk otherwise. I am sure you know that ReA sometimes goes into remission. It looks like your case isn't too severe - am I right? I hope yours goes away. My case is severe and extremely painful so I am not very hopeful at this point of going into remission. It has been three years since the symptoms first appeared.

Thanks for your comments.

istone
Regular Member


Date Joined Nov 2006
Total Posts : 77
   Posted 1/22/2007 5:56 AM (GMT -7)   

hi

i have the same like u bladder and sinus infection that dont respond to antibiotics

i try short time and infection relapsed again. did u find a dr who treat your ReA`?

which joints are affected`?  i have all the joints affected from jaws to the toes.

all the tests came negative i suffer from 1 year and no dx even treatment.

i dont know what to do im so afraid to not developed RA cos u know all these infections can develope RA after long time. so long time antibiotcs didnt help u to eradicate infection`?

 

pls reply kind regards

EveSasser said...
Reactive arthritis is triggered by an infection. If you have an active infection, you have to get rid of it, but most reseachers don't believe that you can benefit from antibiotics after the infection is gone. Old doc believed that sub clinical or micro infections could continue to trigger the arthritis and needed to be eradicated to keep from tiggering the arthritis needlessly. For instance, I have been exposed to mycoplasma but have no idea if I have an active infection. New doc has no interest in the topic and believes it is bunk. Right now, I need the new doc to help me get on my feet and do the conventional things - prescribe Enbrel, send me to have an MRI of the lumbar spine, and refer me to physical therapy. However, I may pursue the antibiotic protocol later on. I was in touch with someone from The Road Back who sent me names of some docs that prescribe antibiotics for those with ReA.  Has anyone had experience with this protocol over a period of time and did it make a difference?  I have been on antibiotics for nine months, and I always have some kind of infection, so I am not a good case study. Also, the new doc said I have to find someone to manage my infections because he doesn't want to do that. Old doc did perform this service. I have chronic bladder and sinus infections, and I have to go on antibiotics at the first sign of trouble because I am taking Enbrel. Does anyone else have a similar problem and, if so, what kind of doctor are you seeing to manage your infections? Any advice would be very helpful.

erin.K
Veteran Member


Date Joined Mar 2005
Total Posts : 3148
   Posted 1/22/2007 7:19 AM (GMT -7)   
Just to add....I recieved 4 years of heavy antibiotic cocktails (grams and grams per day) when being treated for Lymes and Lymes Reactive arthritis and shortly after as treatment for RA (in a pending DX at that time).
In short, the joint pain initially was worse when starting AX therapy, and then it helped a lot. However, for my case, AX therapy wasn't enough after time.
I do believe it to work though.
Take care.
Erin
Arthritis Forum Moderator
Active Severe Rheumatory Arthritis. Crohns Disease. Vasculitis of legs. A.Chiari Malformation & right brain venous anomoly. Partial Complex Seizures. MVP & Tricuspid Valve Prolapse. Rheumatic heart & lung. Previous Lymes Disease for 10 years.
Meds: Remicade infusions Q3 weeks; Intra-articular knee injections; Imuran; Mesalamine; Prednisone tapering from 120mg; Meclizine; Reglan; LidoDerm; Diazepam; Restaril; Dilaudid; Avinza and too many others. 


EveSasser
Veteran Member


Date Joined Mar 2006
Total Posts : 808
   Posted 1/22/2007 7:34 AM (GMT -7)   
istone,

I have seen two rheumatologists. They both diagnosed me with reactive arthritis. My pain is in my neck, lower back, and hip area. It is severe.

Erin, the pain that I had on 1000 mg of biaxin was unbearable. I don't believe it is safe for me to take high doses of antibiotics. My lyme test showed two reactive bands, and the doctor wanted to give me IV. Not enough evidence in my opinion to do IV therapy so I declined. Thanks for sharing the information, though. It is interesting that the therapy helped but not enough. I hope you are doing okay.

Eve

istone
Regular Member


Date Joined Nov 2006
Total Posts : 77
   Posted 1/22/2007 3:03 PM (GMT -7)   
hi
are your joints swollen? do u have inflammation red hot joints? i dont have.i have jont attack always. now i have tailor's bunion inflammation and pain.
do u take antiinflammtory meds? i take mobic and is very hard for my stomach and bowels too.
what treatment do u think will work if u think AX is not worth anymore.
did u tried sulfasalazine or MTX? what about enbrel does work ? did your dr indentified bacteria that triggered your arthritis?
 
 
 
EveSasser said...
istone,

I have seen two rheumatologists. They both diagnosed me with reactive arthritis. My pain is in my neck, lower back, and hip area. It is severe.

Erin, the pain that I had on 1000 mg of biaxin was unbearable. I don't believe it is safe for me to take high doses of antibiotics. My lyme test showed two reactive bands, and the doctor wanted to give me IV. Not enough evidence in my opinion to do IV therapy so I declined. Thanks for sharing the information, though. It is interesting that the therapy helped but not enough. I hope you are doing okay.

Eve

EveSasser
Veteran Member


Date Joined Mar 2006
Total Posts : 808
   Posted 1/22/2007 6:31 PM (GMT -7)   
I have terrible pain in my neck and back. It feels like somebody put barbed wire inside my skin. I tried all sorts of NSAIDS but they weren't strong enough. The Enbrel is very good. It is a risky drug in some ways but it is effective. If Mobic is an NSAID it could be doing terrible things to your stomach and gut because it can cause bleeding. If you already have stomach problems, you probably should find another way of easing the inflammation. I was infected with mycoplasma and salmonella. ABX may help if you catch the disease in the early stages. Even then, you might need to take them for a couple of years. There are doctors that specialize in the antibiotic protocol. I don't know how scientific it is, but some people believe it can help.

Marius123
Regular Member


Date Joined Aug 2006
Total Posts : 142
   Posted 1/22/2007 7:31 PM (GMT -7)   
EveSasser said...
I have terrible pain in my neck and back. It feels like somebody put barbed wire inside my skin. I tried all sorts of NSAIDS but they weren't strong enough. The Enbrel is very good. It is a risky drug in some ways but it is effective. If Mobic is an NSAID it could be doing terrible things to your stomach and gut because it can cause bleeding. If you already have stomach problems, you probably should find another way of easing the inflammation. I was infected with mycoplasma and salmonella. ABX may help if you catch the disease in the early stages. Even then, you might need to take them for a couple of years. There are doctors that specialize in the antibiotic protocol. I don't know how scientific it is, but some people believe it can help.
omfg, taking abx for such  a long time can cause you GI problems. They kill everything. It's not safe. That protocol. I reject!
Official dx, but I have doubts: chronic reiter's syndrome (1yr and 6 mnths).
suffer form occasional conjuctivitis outbreaks, mild arthritis, also showing some short lived mild aches all over the body


EveSasser
Veteran Member


Date Joined Mar 2006
Total Posts : 808
   Posted 1/22/2007 7:55 PM (GMT -7)   
I definitely understand your concerns. I'm not recommending it just providing information.
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