Why do so many Crohn's patients have rheumatologists?

i've been wondering the same thing, thanks for putting the question out her. i don't know why either i'd assume "rheumies" would be for people with RA?

A lot of people with Crohn's develop arthitis issues, like RA. Pretty darn common actually. I've got my referral recently, didn't get one till my joint inflammation kicked in with a flare. Crohn's effects outside of the intestines in many ways, which causes us to have to see many different kinds of doctors unfortunately.

My son who was diagnosed with CD two years ago had no joint pain initially and only 4 months ago developed it as his Remicade would wear off each month. As soon as he got his Remicade the joint pain would disappear within a few days. The joint pain would preceed D and stomach pain as inflamation would increase. In many Crohns patients the arthritis is a symptom of inflamation rather than a new disease entity. Usually if you deal with the gut inflamation the joint inflamation subsides. In most cases they are one disease rather than two.

How long has the pain been going on? If it's been going on for a few months, you should talk to a doctor about it...

I'm pretty sure that the two are connected. My guess is that the gut inflammation causes the joint inflammation directly. Crohn's is associated with high IgE levels in the blood. IgE is a trigger for the mast cells which are known to be active in the progress of RA. Unfortunately, there is no simple solution like an IgE inhibitor - not that they don't exist. It is just that there is no complete extinction of the response. The observations have shown either an initial relief followed by a worsening or no initial relief and a slow improvement thereafter. They really don't know why and I guess that they don't want to make matters worse. There is likely another modulator or several that is involved in the process.

Celey said...
On the CCFA website it says only 25% of people with Crohn's develop arthritis issues... I think... there's just a lot of them that visit this board...

Or maybe the CCFA website is wrong... at any rate...

You guys shouldn't worry about it unless you start having joint pain symptoms...

I wonder if that includes issues caused by the medications we have to take, and just some joint pains but don't lead in to more serious problems (how many people shrug some of the more minor aches and pains off? At least at first anyway).

Or like you said, we are all just "lucky." LOL

We see the Rheumy for inflammatory arthritis, osteoarthritis and even other types of arthritis. The joint pain isn't always related to inflammation or medications. I suffer with fibromyalgia and osteoarthritis secondary to my Crohns. I am on no meds for any of it except for pain killers as I am not quite ready to go on the big gun medications yet. I have also found that I have alot more wear on my bones than someone my age should have. That more than likely is caused by alot of Prednisone use.

I personally believe everyone should have a Rheumy on board. If you aren't having joint pain now, I think you will sometime in your life. Mine pretty much developed in the last 10 years or so. And its getting worse as I get older.

Bone density checks are very important even in younger crohnies.

But I have a rhuemy because I had such horrible joint pain I could not walk, no pain killer was touching it, except that it made me sleep. Little did I know at the time I had lupus from the remi.

I had the joint pain a few years after the Crohn's pains started, but hadn't been diagnosed with Crohn's yet and no one put the two together.  I was tested for Lupus, RA, etc. for swelling, painful joints.  Only after I started seeing a new GI who has Crohn's and knows more than my last GIs, did he tell me that a lot of Crohn's patients get arthritis also.  He really doesn't do much for the arthritis, but has me see the rheumy for that.  He's even told me that he has some patients with Crohn's who have no gut symptoms, just arthritis.  With me, the arthritis is worse than the Crohn's right now.  But, the arthritis meds are also causing stomach pains and ulcers, so it's a struggle finding the right meds. 

I've had crohn's for 28 years and luckily I have not had much in the way of joint pain until appro. 1.5 years ago when I develped remicade induced lupus. Now that was painful, I could hardly move. I never want to experience that again, but that is when I added a rheumy to my list of specialists.

Julia

Sorry, I don't think that my last post was very clear. I am pretty sure that the IgE that Crohn's produces in the blood is responsible for RA developing. IgE is a trigger for the mast cells and it is established that the mast cells in the synovia are responsible for the development of RA. There are some proteins in gluten that resemble the cartilage proteins and thus Mast cells activated with IgE expressing that protein sequence cause the inflammation in joints. Stopping gluten in the diet is only part of the battle since cells in the blood continue to manufacture those IgE types for years after. That is why the report of vitamin E reducing the levels of IgE in the blood is exciting. It has the possibility of helping prevent or minimize the progression of RA.

IMHO....PREDNISONE!