Colitis, or ulcerative colitis, is a chronic inflammatory disease affecting the inner lining of the colon and rectum. In its worst form, it can be debilitating or life-threatening. Ten to 25 percent of colitis sufferers experience symptoms of arthritis, which is inflammation of the joints, directly related to their condition. Despite the similarity in symptoms, colitis-related arthritis differs substantially from classic arthritis, and the course of treatment must be tailored to the special circumstances associated with colitis.
Diagnosis
In order to diagnose colitis-related arthritis, your doctor must first eliminate the possible presence of rheumatoid arthritis (RA). While colitis-related conditions can partially mimic RA, they do not generally cause deformation of the joints. Additionally, colitis-related arthritis does not usually affect joints symmetrically in the manner characteristic of RA.
If you are diagnosed with colitis-related arthritis, your doctor must determine which of its three basic forms is present: peripheral, axial or ankylosing spondylitis
Treating Peripheral Arthritis
Peripheral arthritis can occur in the wrists, elbows, ankles or knees. A transitory condition, it mirrors the rising and falling degrees of inflammation in the colon and rectum. Pain can also afflict different joints at different times. If you are diagnosed with peripheral arthritis, your symptoms will likely disappear when your bouts of colitis end, and the condition does not typically cause long-term damage.
Treatment will center on managing your colitis symptoms, since the inflammation and the arthritis are directly related. Your doctor may choose from a number of medications, including anti-inflammatories such as sulfasalazine (Azulfidine), olsalazine (Dipentum), mesalamine (Asacol) or corticosteroids. Alternatively, he may prescribe immune suppressors such as cyclosporine (Neoral), azathioprine (Imuran) or infliximab (Remicade). Non-steroidal anti-inflammatory (NSAID) medications such as aspirin or ibuprofen may also be used. While NSAIDs tend to worsen colitis inflammation in many patients, some tolerate them well enough for short-term treatment. If your diagnosis is recent, ask your doctor to explain the risks and benefits of any treatment she may prescribe.
Treating Axial Arthritis
Axial arthritis, or spondylitis, is characterized by pain and stiffness in the lower spine and sacroiliac. More serious than peripheral arthritis, if left untreated it may create fusion of the spinal bones and permanent movement restrictions in the lower back. Axial arthritis does not typically respond well to direct treatment of colitis symptoms, and if you have this condition your doctor will likely focus treatment on exercises to maintain your range of motion. Additional relief may be gained from rest and the use of moist heat, or NSAIDs if they are well tolerated. The condition usually does its worst damage by age 40.
Treating Ankylosing Spondylitis
In some rare cases, ankylosing spondylitis (AS) may be diagnosed. Along with the symptoms associated with axial arthritis, effects from this condition can include inflammation of the heart valves, lungs and eyes. In addition to physical therapy, AS may be treated with the immune suppressor infliximab (Remicade). Unfortunately, permanent deformation is still a distinct possibility. Consult your doctor and physical therapist for a broad approach to combat the effects of AS.
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