The Rheumatology Connection to Inflammatory Bowel Disease

While rheumatological manifestations among patients with inflammatory bowel disease (IBD) are frequent and include secondary osteoporosis and hypertrophic osteoarthropathy, complications of IBD may also cause joint pain and rheumatoid arthritis, according to recent research conducted at Wayne State University in Detroit, Michigan.

"The tricky part remains to identify if the joint pains are occurring as an extra-intestinal manifestation of IBD, side effects to therapy, or if there is an underlying concomitant joint disease," the authors said during the poster presentation in the Crohn’s and Colitis Congress 2023 in Denver, Colorado. "This stems from the fact that both IBD and rheumatoid arthritis are autoimmune conditions that arise due to the influence of environmental and genetic factors that may be identical between the two conditions."

For their study, the authors investigated data collected from 228 clinic patients treated at Wayne State in 2018, average age 28. More than 95% of these patients had Crohn disease, more than half (60%) of these patients were women, and roughly three-fourths (77%) of the patients were African American. The most common rheumatological manifestation among these patients with IBD was ankylosing spondylitis, and the most frequent manifestation was the general category of rheumatoid arthritis.

“The fact that the majority of clinic patients were seen by both gastrointestinal experts and rheumatology experts and were on effective therapies for their IBD and Rheumatological manifestations is encouraging,” the authors wrote. Both gastroenterologists and rheumatologists should be vigilant to identify the co-existence of these conditions and follow-up these patients for better outcomes, they said.

Reference:
Almujarkesh MK, Haider M, Kaur J, Abu-Heija A, Naylor P, Sarakbi H and Mutchnick M. IBD and rheumatological disease overlap in a predominantly African American clinic population as compared to a national inpatient database. Presentation number: P098. Presented at the Crohn’s and Colitis Congress 2023. January 19, 2023. Denver, Colorado.