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colitis and RA / joint pain

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Ulcerative Colitis
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Posted 7/10/2013 5:34 AM (GMT -6)

Hi....long time reader...first time poster!!

 

I’ve had colitis for 7 years and thankfully it has been well under control. In March I had a small flare-up and for the first time noticed a little knee pain. That went away when I got the flare under control in April. However in June I went into another flare, minor enough only this time I did get an attack of mild joint pain flitting all over my body. My knee would get sore, then heal, my hands and fingers would get sore for a few days then get better, my shoulder would get sore etc. I even had some toothaches and jaw pain accompanying the flare. My doctor put me on a course of steroids and I’m due in for a scope in a few weeks. However my blood tests also indicated I was positive for Rheumotoid Factor (RF) meaning the joining pain could be Rheumotoid Arthritis (RA).

 

My doc did say that if you have high RF then 90% chance you have RA. But he’s not sure how this stat holds for a person already suffering from colitis / autoimmune conditions in general. He said he thought colitis and RA were very rare in association (Crohns is more associated with RA). He also noticed that I have no swelling at all, no nodules and very little morning stiffness even when the joints were sore.

 

So he’s repeating bloods and taking x-rays but has said its possible that even then they won’t know for sure whether its RA or just related to colitis.

 

I was just wondering whether anyone had been through these symptoms particularly with a high RF blood measure with colitis. Any other thoughts or opinions would be much valued

Posted 7/10/2013 5:39 AM (GMT -6)
You can have a high RF and not get RA. You can also have low or no RF and get RA (that's called sero negative RA). There are literally 100's of different types of arthritis but the most common for UC'ers is Peripheral arthritis. I have this. The joint pain mirrors the inflammation in your gut. Once a flare settles down, the joint pain lessens. It's non-damaging but migratory.
Posted 7/10/2013 5:49 AM (GMT -6)
thanks Red_34. Just a bit confused at the moment and overwhelmed at having 2 autoimmune diseases. i always knew i was at risk of join pain but thought it would be PA - type stuff. Defo seems to be flaring when my colitis is bad but doc still worried on high RF.
Posted 7/10/2013 7:09 AM (GMT -6)
You should see a rheumatologist to get to the bottom of this. Like Red said, the most likely explanation for your joint pain is enteritis arthritis, which is not damaging to joints. For many years, my main IBD complaint was joint pain (hands and wrists), not bowel issues. I take sulfazine now, which treats both the joint pain and the bowel inflammation. This has worked well for me.
Posted 7/10/2013 7:26 AM (GMT -6)

I have zero negative RA, which was very hard to diagnose. I had severe pain in the feet, knees and shoulders. I could hardly walk and I could not lift my arms above my head. I finally went to a Rheumatologist and was correctly diagnosed with RA related to my UC. I went for another opinion and got same diagnosis. Both doctors informed me that with RA both joints will hurt. (Both shoulders, both knees etc…)

I was given Cortisone shots, Prednisone, and Methotrexate. The cortisone shots really gave great relief from the pain. I am now on 10mg of Prednisone and Methotrexate. After ten months of treatment, I feel great.

If the pain continues, I would recommend checking with a Rheumatologist.
Posted 7/10/2013 8:27 AM (GMT -6)
Another vote for trying sulfasalazine as your ASA as it can help with UC and joint pain.
Posted 7/10/2013 8:34 AM (GMT -6)
thanks for all replies...NABO when you say ur RA is related to ur UC does that mean it flares when ur UC flares?
Posted 7/10/2013 12:13 PM (GMT -6)

No, they do not flare at the same time. I think because the are both Autoimmune related they consider the RA and UC to be associated. Another reason this is suspected is because my rheumatoid factor is zero negative. Three different doctors including my GI suggested this. Both my Rheumatologist and GI think I should try Humira, because it is used to treat both conditions. I am resisting going to biologics at this time, but it is an option for future consideration. There is literature on the web related to RA associated with UC.

Posted 7/12/2013 3:20 AM (GMT -6)
hey thanks people for all your help here. they x-rayed all my joints and they all came back negative for any problems. doc said joints looked great. so he's confused. he said he finds it highly coincidental that the joints flared up for a week at the same time as my colon flared. he wonders is it all colitis driven or did i pick up a virus that is flitting around my body and causing an immuno-response. he figures it might be time to scope my bowel...havent done one for a couple of years. luckily i feel really great on low dose of pred
Posted 7/12/2013 4:11 AM (GMT -6)
Interesting thread...now that I think about it, I believe the severe pain in my hips, knees and ankles that I suffered for a month BEFORE my gut symptoms started flaring may have been the first sign of an impending flare.

Here is a link
http://www.patient.co.uk/doctor/Enteropathic-Arthropathies.htm
Posted 7/12/2013 6:12 AM (GMT -6)
Enteritis arthritis causes no damage to joints, Charlie, so your x-rays are consistent with you having joint inflammation as a part of your IBD, not RA.
Posted 7/12/2013 8:08 AM (GMT -6)
yeah my doc was saying that too...i had a little shoulder ache for 2 years so i had assumed that was when the RA began but he said the shoulder looked fine....he wondered whether i have a viral infection that is causing immuno respones in joints and bowel...
Posted 7/18/2013 9:44 AM (GMT -6)
seems to suggest that UC and RA are rare in association compared to other pairs of autoimmune conditions....

http://www.scielo.br/scielo.php?pid=S0482-50042012000400014&script=sci_arttext&tlng=en
Posted 7/18/2013 10:15 AM (GMT -6)
interesting...i cam across the following on web....not sure if it is saying that IBD is correlated with RA or is it just suggesting that high rheumotoid factor in the blood is prevalent in CD / IBD patients...maybe some members can make more sense of the technialities

The behaviour of some serological aspects of autoimmunity was studied in patients with inflammatory bowel disease (IBD) by determining the incidence and levels of serum IgM, IgG and IgA rheumatoid factors (RF) and of circulating immune-complexes (IC) in 67 patients suffering from ulcerative colitis (UC) and 53 from Crohn's disease (CD). Sera from 40 young healthy subjects were included as controls. RF were detected by an enzyme linked immuno-assay (ELISA) and IC by the CIC-conglutinin and the CIC-C1q assays. ELISA detected a higher incidence of IgM RF in both UC and CD groups than the routine agglutination tests, although the mean levels were non significantly higher than in controls. Mean IgG RF levels were significantly above normal in UC and CD patients, the latter showing a greater incidence of elevated values and higher mean levels. IgA RF were significantly elevated only in CD patients; mean values for the UC group were within the normal range. The CIC-conglutinin test did not detect a significant incidence or high mean levels of IC and the CIC-C1q assay turned up a sizeable number of positive samples only in the CD group. Although still only preliminary, these overall findings suggest that RF activity is somehow present in patients with IBD. The greater prevalence of IC in CD patients, together with the patterns of IgG and IgA RF support the concept that this disease possibly involves autoimmune phenomena more than ulcerative colitis.
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