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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Causes Reactive Arthritis With Severe Joint Pain While Treating IBD?

Hello Sir, I am suffering from some unknown IBD like disease because of which I was loosing hemoglobin from last 7 years. I am responding well to the medicine from past 2 months but I am now suffering from last 6 months with reactive arthritis with severe joint pains in lower back knees , shoulders, ankles etc. all over my body. The pain has aggravated from past 2 months. I am happy to have been recovering from the IBD issue with improved blood count, but the pain is unbearable. Please help.
Thu, 29 Sep 2022
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Anesthesiologist,  's  Response
Hello,

Reactive arthritis, is an autoimmune condition that develops in response to an infection. It has been associated with gastrointestinal (GI) infections with Shigella, Salmonella, Campylobacter, and other organisms, as well as with genitourinary (GU) infections (especially with Chlamydia trachomatis).

In IBD, there can be extra intestinal manifestations in 10-20% of patients like arthritis, uveitis, liver disease. Septic and pyogenic arthritis can also mimic reactive arthritis. Treatment options are NSAIDs like Indomethacin and Naproxen as the mainstay of treatment. Acitretin is to be combined with NSAIDs. If there is no improvement after 1 month of NSAIDs or if they are contraindicated, then sulfasalazine or methotrexate can be used

Corticosteroids can also be added for reduction of inflammation. Antibiotics to treat the underlying infection of reactive arthritis. Anti TNF medications such as etanercept/infliximab can be used in resistant cases. Daily physical exercise for 30 min at least 5 days a week is necessary after pain reduction. Please ask your physician to prescribe above mentioned drugs to get relieved from severe joint pains.

Take care. Hope I have answered your question. Let me know if I can assist you further.

Regards,
Dr. Pallavi M., Anesthesiologist
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What Causes Reactive Arthritis With Severe Joint Pain While Treating IBD?

Hello, Reactive arthritis, is an autoimmune condition that develops in response to an infection. It has been associated with gastrointestinal (GI) infections with Shigella, Salmonella, Campylobacter, and other organisms, as well as with genitourinary (GU) infections (especially with Chlamydia trachomatis). In IBD, there can be extra intestinal manifestations in 10-20% of patients like arthritis, uveitis, liver disease. Septic and pyogenic arthritis can also mimic reactive arthritis. Treatment options are NSAIDs like Indomethacin and Naproxen as the mainstay of treatment. Acitretin is to be combined with NSAIDs. If there is no improvement after 1 month of NSAIDs or if they are contraindicated, then sulfasalazine or methotrexate can be used Corticosteroids can also be added for reduction of inflammation. Antibiotics to treat the underlying infection of reactive arthritis. Anti TNF medications such as etanercept/infliximab can be used in resistant cases. Daily physical exercise for 30 min at least 5 days a week is necessary after pain reduction. Please ask your physician to prescribe above mentioned drugs to get relieved from severe joint pains. Take care. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Pallavi M., Anesthesiologist