Rheumatoid arthritis patients have a higher risk of developing lower gastrointestinal (GI) problems such as ulcers and bleeding, this according to a recent study published in the Journal of Rheumatology. The research looked at the incidence of upper GI tract problems vs. those of the lower GI tract. Upper GI issues declined over a 28 year study for people with RA while lower GI tract problems held steady over the same time period.
[Upper GI issues occur between the mouth and end of stomach while lower GI tract issues affect the large and small intestines.]
Upper GI issues in RA patients are partially attributed to the use of NSAIDs. In the lower GI, there is not enough to find the link between RA and the lower GI problems. However, smoking, use of corticosteroids (i.e., prednisone, cortisone), prior upper-GI disease and abdominal surgery were all identified in this study as increasing the risk in RA patients.
“We are still seeing about a 50 percent increase in lower-GI problems in people with RA compared with those without it. More attention is needed to address lower-GI problems,” says study co-author Eric Matteson, MD, chair of rheumatology at the Mayo Clinic in Rochester, Minn. “Doctors and patients should be aware of the increased risk of lower-GI problems that can be related to RA and/or its treatments, and of the risk factors that can lead to lower-GI problems. Stopping smoking and avoiding corticosteroids can reduce the risk.”
The study confirms that people with RA have more upper and lower GI problems and are more likely to die of GI problems than people without the disease. Experts believe that this is primarily due to the weakened immunity presented by RA. That higher risk is at least 70 percent higher for those with RA than those without the disease.
Specific GI conditions researched to RA include infectious colitis, lower GI bleeding, and perforation and diverticulitis. When GI events occur in RA patients, they are more likely to be serious in RA patients and even require hospitalization.
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