The exact reason for enteropathic arthritis remains unclear, but it likely results from a combination or interaction of several factors.
Both Crohn’s — a type of inflammatory bowel disease (IBD) — and arthritis involve inflammation. Crohn’s may increase the risk of inflammation in other parts of your body through various mechanisms.
“Although primarily a disease of the gastrointestinal tract, Crohn’s can affect multiple organs,” says Jane Onken, MD, a professor of medicine specializing in gastroenterology at Duke University School of Medicine in Durham, North Carolina. Extraintestinal manifestations include oral ulcers, inflammatory conditions of the eye, certain skin lesions, and joint aches.
Genetic Predisposition
People with Crohn’s who develop arthritis often have changes in certain genes.
Luminal Microbiota
The luminal microbiota is the community of bacteria and other microorganisms that live within the gut. A balanced gut microbiome helps you digest food and keeps the gut healthy.
Leaky Gut
Immune System Dysfunction
Medication Use
Some Crohn’s medications can cause joint pain that’s not necessarily arthritis.
- infliximab
- azathioprine, in some people
- steroids, when used for too long or stopped too quickly
Dr. Onken says that doctors often prescribe prednisone, a steroid, to treat both gut and arthritis symptoms in Crohn’s. “A potentially debilitating side effect of prolonged or frequent prednisone use is bone loss that can lead to osteoporosis, compression fractures of the spine, and more.”
For this reason, she says, “It’s important to try to minimize the use of prednisone whenever possible.”
People who use prednisone for a long time need close monitoring of bone density.
“Some Crohn’s patients are also at risk for bone loss due to vitamin D deficiency, so levels should be checked and replaced when necessary,” Onken says.
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