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Posted 8/15/2011 9:14 PM (GMT 0)
Hi,

can anybody offer any help or advice on treatments that have worked for them with Colitis and athritis?

 I've got pan colitis with flareups every couple of weeks which has been going on for about a year now (being treated with Azathioprine 150mg not really helping), but I've recently been diagnosed with inflamatory athritis affecting all joints on my arms and legs.  The consultant put me on Sulfasalazine 2gm a day about a month ago but nothing is happening except joints are getting more painful :(  Should I be pushing for stronger medicines, can my joints ever recover, if my bowel is removed do the joints improve ?

help

 

Posted 8/15/2011 9:18 PM (GMT 0)
about 25% of IBD patients have joint pain associated with their bowel disease. A lot of folks think that joint pain comes on when bowel inflammation is not controlled. If you are having significant pain I'd think a course of oral steroids would knock everything into remission and give you some relief.

I take 1.5 g of sulfazine/day and that has helped a lot with joint pain in my hands and wrists, less so with the knee and lower back. I think you can ask for an increase in your sulfazine dose, but I'd also recommend seeing a rheumatologist.

Colectomy seems like an idea that would work, but that is a question for your medical team.
Posted 8/15/2011 9:33 PM (GMT 0)
thanks for the advise, at least you got some relief how long did it take to start working,,my knees and ankles are the work :(

I've got to avoid steriods as was taking 60mg tapering down for about 5-6 months and I might have weakened bones currently under investigation, hence looking for something else.

It was a rheumatologist who diagnosed my arthtritis but he just said wait and see if the sulfasalizine works just I'm really worried and would prefer to hit this arthritis with the hardest treatment available.
Posted 8/16/2011 1:16 AM (GMT 0)
Have you had any blood work to determine if whether or not you have RA? What sort of testing have you had?
Posted 8/16/2011 1:56 AM (GMT 0)
I put the sulfazine into my pill box gradually - starting with 500 mg and moving up to 1500 mg over a few weeks. I also was tapering entocort, which my GI prescribed to get me some effective relief quickly. I have Crohn's, so entocort was a reasonable shot at treating the assumed inflammation, and it did relieve my hand pain. The transition between sulfazine and entocort took a week or two where I still had hand pain, and then it all settled down.

I suggest you talk to the rheumatologist again about your issues. Sulfazine can be prescribed up to 4 g/day, like the other 5-ASAs we take, but side effects may become more of an issue at higher doses.
Posted 8/16/2011 2:11 AM (GMT 0)
My colon symptoms are relatively better, but the joint pain persists.  I'm at 5,000 mg a day sulfasalazine, and the sulfa has helped more than anything for the joint pain.  Unfortunately, there aren't a lot of good treatments for IBD-related arthritis.

The rheumatologist I see doesn't think that sulfasalazine will do much for back, neck, and hip pain.  I will say, though, that my knees, ankles, and wrists are much, much better with the sulfa.

It took a good three months before I saw any difference.  It does take time for the sulfasalazine to start working.

Posted 8/16/2011 2:29 AM (GMT 0)
can my joints ever recover, if my bowel is removed do the joints improve ?

In theory it should improve your joints but I would consult with your doctor about the odds of arthritis going away. I suffered severe arthritis along with other extraintestinal symptoms during my last flare but those symptoms disappeared when I went into remission. So I would try very hard to get out of your flare and hopefully your arthritis symptoms will lessen. Flagyl, an antibiotic, helped me get out of my flare.

One theory why arthritis manifests during IBD is because of Leaky Gut caused by inflammation. Food and bacteria from the digestive system leaks into the circulatory system and gets transported everywhere causing eye inflammation, liver problems, arthritis in the joints, kidney problems, etc.

en.wikipedia.org/wiki/Leaky_gut
Leaky gut is a name used to describe intestinal or bowel hyperpermeability. Tight junctions (TJs) represent the major barrier within the pathway between intestinal epithelial cells that line the digestion tract. Disruption of TJs leads to intestinal hyperpermeability (the so-called "leaky gut") which has been proposed by some researchers to involve a relationship with acute and chronic diseases such as systemic inflammatory response syndrome (SIRS), inflammatory bowel disease, type 1 diabetes, allergies, asthma, and autism
Posted 8/16/2011 9:37 AM (GMT 0)
I have UC and ankylosing spondylitis (oh, how I wish spellcheckers would learn these words!), and my rheumatologist suggested sulfasalazine, but all it did was make me really nauseous. I'm on Asacol now, and I have an appointment with my gastroenterologist today to ask, amongst other things, about painkillers for both my UC and my arthritis. Has Remicade worked for anyone? I won't go on steroids unless I'm near death because of the side effects, and I'm not sure about how to ask for the "good" painkillers without sounding like a drug addict. *sigh*

I think just getting my UC into remission helps a lot because my medication, whatever I do take, gets absorbed better and doesn't just, ahem, go right through me. I've heard that boswellia (a natural herb and anti-inflammatory) works well, but, like sulfasalazine, it made me nauseous. But lots of people have had luck with it.
Posted 8/16/2011 2:36 PM (GMT 0)
My experience with UC related arthritis has been more frustrating than the UC itself. I have axial arthritis (which may be AS, but has not been officially diagnosed as such). I had good results using Humira for a few months, but ended up getting bad sinusitis and then bad gastritis, so I decided to stop using it.

Before the "itis" mess, Humira worked great, however. I am now taking doxycycline 200mg/day and this seems to be helping.

Foods are a factor in arthritis (as well as with all inflammatory conditions). I know it has never been officially linked, but nightshade vegetables seem to make my arthritis worse, for example. Everyone is different, so what worked for me may not work for others, though. Diet is something that should definitely be considered when trying to get out of pain.

Bovine colostrum may be something to try. It has immune modulating affects. It can also help to heal a leaky gut.
Posted 8/16/2011 4:08 PM (GMT 0)
@mamudoon

i am keeping both UC and AS in check with diet. I also take mesalasines.

thanks to this i do not need anymore pain killers for my AS problems.

good luck.
Posted 8/16/2011 4:11 PM (GMT 0)

Red_34 said...
Have you had any blood work to determine if whether or not you have RA? What sort of testing have you had?

Hi Red_34

Not yet, I've got an appointment with another consultant next Friday where I'm going to insist they do such work, what tests should I be asking for,,I just can't belive it takes only 2-3 months for my whole body to develop RA as my back is now starting to ache?  its so difficult to drive/work etc. :(

Posted 8/16/2011 4:18 PM (GMT 0)
thanks for all your replies, my RA doesn't seem to vary with flareups its always the same, although i'm pretty much in one continual flare but I should expect to see variation does anyone else have continual arthritis pain?
Posted 8/16/2011 4:19 PM (GMT 0)
If you are seeing a Rheumy, they should know what to test for. You may not necessarily have RA. There are literally hundreds of different forms of arthritis. But RA and Peripheral arthritis are the most common seen in IBD. I don't have RA but I do have Peripheral. Peripheral is the inflammation that gets to the joints and it wax and wanes with Uc flares. I also have mild OA in my hands and right hip.
Posted 8/16/2011 4:24 PM (GMT 0)

Red_34 said...
If you are seeing a Rheumy, they should know what to test for. You may not necessarily have RA. There are literally hundreds of different forms of arthritis.

Agreed. I have ankylosing spondylitis (a form of spinal arthritis), and both AS and IBD are closely linked with the antigen HLA-B27. I've never been tested for it, but given that I have both diseases (as well as Sjogren's Syndrome, another condition linked with HLA-B27), I'm almost certain I have it. Reactive arthritis is also closely linked with it.

And I agree with runcycle in that the arthritis poses more of a problem for me than the colitis. At least the colitis goes into remission periodically. The AS doesn't.
Posted 8/16/2011 4:52 PM (GMT 0)
what tests should I be asking for,

One of the most popular supplements on this forum is vitamin D. It is not only effective for IBD but also helps ameliorate arthritis and fibromyalgia. Get your vitamin D levels check during your next blood work. Most find that their D levels are very low when first tested. (Google vitamin D and you will see that it is a panacea for almost everything from cancer to heart disease.)

Other supplements for chronic arthritis are fish oil (very popular here) and SAMe. For some reason these same supplements for arthritis are also known to be helpful for depression.

The above link about leaky gut said that glutamine may help repair digestive tissue.
Posted 8/16/2011 8:14 PM (GMT 0)
Weight bearing exercise helps me alot. I have had some NASTY arthritic episodes. It happened in my wrists and feet, at different times. Starts out feeling like my foot is falling asleep and progresses to limping in excruciating pain! Fortunately I have been in a real good 99% of the time remission for about 5 years. Good Luck! dB
Posted 8/16/2011 9:04 PM (GMT 0)
my arthritis was so bad I could hardly walk or use my hands...the only thing that worked for me was 6 rounds of Remicade, and I haven't had a problem in over a year being off the remicade

I had Peripheral arthritis and not RA
Posted 8/16/2011 9:31 PM (GMT 0)
Voltaren (pills) worked for me, for a temporary arthritis I was feeling in my rib cage.
Fortunately sometimes the arthritis is just temporary (I am sure there is a technical name for it).
Posted 8/17/2011 12:29 AM (GMT 0)
Peety, didn't the Voltaren bother your Uc at all?
Posted 8/21/2011 7:56 AM (GMT 0)

nightside of eden said...
my arthritis was so bad I could hardly walk or use my hands...the only thing that worked for me was 6 rounds of Remicade, and I haven't had a problem in over a year being off the remicade

I had Peripheral arthritis and not RA

Hi nightside,

Did you get symetrical pain i.e. in both hands and both legs, I didnt' think Peripheral arthritis did this nor was in the hands, I have pains in knuckles as well as wrists (as well as every other joint, symetrically), I'm really depressed at the thought of not being able to walk or do anything! what with the pan colitis and other upper GI symptoms is there any point carrying on, how do other people carry on with their lives?

Posted 8/21/2011 4:54 PM (GMT 0)
 

I've been suffering with pretty awful arthritis related UC, meaning the arthritis came WITH the UC, but hasn't left even though I am pretty much in remission.

So, here's what I've found out, perhaps it can help you too?

https://www.healingwell.com/community/default.aspx?f=38&m=2193025

What do you think?

Posted 8/21/2011 10:03 PM (GMT 0)
I was diagnosed a little less than a year ago with arthritis related to colitis. I've always used just tylenol arthritis, along with a muscle relaxant (extremely mild) to help me sleep. I also try to walk daily (as in, 60 mins plus each day), and ice my joints when they really bother me.

I also try to wear arthritis-friendly shoes, and avoid anything that doesn't offer support.

Finally, I just try to meditate and stretch to relieve the aches that come along with it. I think a lot of it just has to be focused on dealing with the UC first, as it comes along with it, and tends to take longer to clear up. Make sure you're getting plenty of rest (mid-day naps can be very helpful!), and not pushing yourself too hard.

Good luck!
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