RA and Ulcerative Colitis?

Hi,

I have had UC for 20 years. (another autoimmune disease-of the colon)Feb.-April 2007, I had TERRIBLE finger pain(all pains always symmetrical) elbows, toes. Swelling, redness. (Colitus not bad during this time, but had stress at work starting in Jan-June.) Pain got better in middle of day, worse again at night. Exhausted. Had seen Rheumy in April, tests negative(all RA type labs, parvo B-19, and Lyme tests), and by the time I got to him, most of pain was gone. We took the "wait and see" approach-maybe a virus he said.

May 2007, NO pain, then June 1+2 a fever with very mild cold symptoms-mostly just fever. June 3, I woke up, fever + cold symptoms GONE, but fingers extremely painful again, and swollen.  NOW, back to Rheumy, pain is awful, and fingers, wrists, elbows, slight shoulder, knee, ankle and toes-all symmetrical. Obviously the same thing as before, but in more areas now. Colitus not good either now.

He put me on Prednis. for 12 days-first 3 days 20mg. then tapering off days 4-12. As soon as we cut the dose on day 4, pain started back, getting worse each day. First day off pred. -horrible pain. Rheumy put me back on 20 mg. prednisone ta few days later until I feel "I have a handle on it " (?) and then call him. The pain is much better, but still feel some at times-especially with stress. Have been on 20 mg. for about 10 days. Swelling in fingers comes back w/ stress too-even on Prednisone.

        Ulcerative colitis has been bad since May (stressful event in May at home)

Rheumy says this is autoimmune joint pain, but too early to label RA. I have read 9-10 books on RA and am pretty sure I have it. Rheumy wanted me to see Gastro. for UC, who just changed my meds. (From Asacol to Colozal) We'll see what happens. DO ALOT OF PEOPLE WITH RA ALSO HAVE COLITIS? (Being that they are both autoimmune?) *My pain does not match Colitic Arthritis, (CA pain is NOT symmetrical, and tends to be in lower extremities.) Gastro. didn't have much info. as far as if the two are related-even auto immune wise. Said he would treat UC, and Rheumy can treat joint pain. (He's a waste of time) Of course can't take any NSAID due to Colitis (Getting a new Gastro. though, who will spend more time) What do you guys think? I am afraid to go off Prednisone, but don't want to blow up either.

*HOW LONG DO REAL PEOPLE WITH RA USUALLY STAY ON PREDNISONE, AND WHAT STRENGTH?

*HOW LONG SHOULD I BE PAIN FREE BEFORE I CALL RHEUMY TO SAY I HAVE A HANDLE ON IT, AND AM READY TO DROP DOSE?

*DOES THIS SOUND LIKE RA TO YOU?

Thank you,

Female -38 yrs.

Kingskid,

I have IBD and the arthritis symptoms in my hands are what got me to the dr. to get dx.  At it's worst, I couldn't even move my fingers enough to squeeze shampoo out of the bottle or brush my hair (thank God for my roommate and boyfriend).  I was sure I had RA.  My rheumy had dx'ed my mom with RA the week before.  Mine wasn't symmetrical and he sent me to the GI.  Luckily for me, the Sulphasalazine that I'm on for my IBD is used for arthritis too.  My GI wants me to taper down the Sulphasalazine, but every time I do my joint pain is back (which is odd since I am on 4000 mg and 1000 mg is what is usually rx'ed for arthritis).  My rheumy has tried to put me on Prednisone a couple of times now when my pain seems to flare (no more heavy lifting for me), but I have refused at least for now.  I have been on Pred for my asthma/bronchitis/pneumonia and HATE the side effects.  Nail down everything cause I'm so hungry I will likely eat the wallpaper off the wall and I'm moody!!! 

Anyways, I don't really have an answer for you other than to say that CA is usually lower extremities, but there are exceptions.

I did meet two people on the Weigh***chers board that had RA, AS, and Crohn's. 

I feel your pain.  Hope you start feeling better!

Hi Traci,

Thank you for the response. It's helpful to know that someone else has had severe hand pain with IBD. I can't take Sulphasalazine due to severe headaches, but I'm glad it has been so helpful to you. The Colazol I started Sat. seems to be working really well so far for UC, so I may need to just wait and see if the joint pain goes away, as the UC leaves, comes back, etc. to try to figure out if it's related. The symmetrical thing worries me, but it is bearable for now with the Prednisone-not a long term solution though. Maybe the Pred. will hold me over until the new Colazol gets UC under control, and I'll try going off of it.

Fingers are worst, but it's weird how some days both knees hurt, others  it's both toes, etc.

I wonder if RA pain moves around while being symmetrical??? Still, fingers are the main thing.

Thank you very much for sharing your hand pain experience!

:)

38 yr. female-not enough time to list all meds I take right now for various things.

Wow, your Rheumy sounds wonderful! I do like mine. He only works 3 days per week, but uses an answering machine (much better than a service) and actually listens to it on his days off, and is willing to discuss details at legnth over the phone.  I am in Southeastern NY-I wonder if it's same one?

I didn't know your med. came in enteric coated-that's good to know.

I loved my OLD Gastro. -but he moved to Isreal recently-that's how I ended up with this other guy I don't care for. I'm going to see another Gastro. from my old guys group now-it's a bit of a ride to the office, but I learned the hard way that it will be worth it.

Take care for now,

and thanks so much!

:)

38 Yr. old female

Hi Elcamino,

Thank you-I agree with you entirely!

You are exactly right on the fact that Pred. is usually only used as a bridge med. while patients are waiting for the DMARD to work in RA.

He said he thought the Pred. would calm down the whole autoimmune thing going on in my body-whatever it was exactly. (I have since learned that Pred. is used in higher doses for UC though-that may explain why it hasn't helped that, but does help the joints.)  

I was hoping the Rheumy would start a DMARD rather than the second round of Prednisone-knowing that the Pred. doesn't stop or slow down the RA disease process, and even if it's not RA, the DMARDS wouldn't be dangerous since they are also used in UC patients.

I mentioned that I really felt from all my reading that it is probably RA, but since he still says it's too early to say that, I didn't suggest the DMARD because we were speaking on the phone-not in person. I voiced my opinion that I did not want to go on Pred. again, but if he thought it was best for my health I would.

I'm wondering if when I taper or go off the Pred, all joint pain will return, then will have to go back on Pred. and a DMARD, until the DMARD begins working. -Sounds like a waste of time huh? -especially when it's so important to stop the disease process early on with RA, to avoid serious damage later. We'll see. I do appreciate that he is careful, not wanting to label me with a Dx that I could take meds for, for years and not really have.

I have read so many books on RA recently, I probably know more about that than the UC I've had for 20 years. I accepted the fact that I have UC years ago, and researching diseases wasn't as interesting to me at 18 as it is now at 38. (wisdom comes with age) I am now taking a second look at UC stuff, digging deeper-not willing to accept illness as a way of life quite so easily-besides finding out new info. in the puzzle is intriguing to me. We all know that no one cares as much about our health as us, and we are far more capable of keeping track of our personal details than Dr.'s who see hundreds or thousands of patients. Anyone who does not take charge of their own health care is crazy!

Maybe I'll leave him a message and give him an update-that I am still having some joint pain-espec. fingers in AM, even on the Pred. Was hesitating on doing that until I had a little more time to observe the results of the new Colazol, just to see if there was any corrolation with changes in UC symptoms and joints. The Pred. sort of masks the joint pain to see that clearly, and I know you can't just stop it abruptly. Seeing the next Gastro. (hoping he'll be worth keeping) in end of July. 

Thank you so much for the info. on your Dad. Did they make the determination that some of the joint pain was actually RA and not due to UC because of a positive RH factor or elevated sed rate? Wondering what it was that enabled them to differentiate the cause of the joint pain-maybe location -UC tends to be lower extremity joints. Sed rates never come back elevated for me since I've been on Asacol for 15 yrs. -controls inflammation.

Thanks!

:)

Thanks SO much. I am very blessed to be able to learn so much through this message board!

:)