Joint pain in hip

It could be. But it could also be just joint pain that comes with IBD. about 25% of IBD patients have joint pain. I use sulfazine to treat my IBD and to reduce joint pain and it has been very effective. But the presence of joint pain, especially when it's bad enough to affect your sleep, is a reason to call your DR. It might also be time to start seeing a rheumatologist. Most of us with joint issues from IBD do this, just because GIs might not be the ones who really get the whole interplay between gut and joints.

Thanks everyone for your responses.Not currently in a flare. Think I will give it a few days and see if the pain subsides, if not I will contact my doctor. I was speaking to my cousins wife yesterday who also has UC and she said she experienced joint pain approx 1 month after going off steroids so I have a feeling it might be that. Have any of you ever tried acupuncture for UC?

If you're on prednisone and have joint pain, I think you need to see someone. Joint pain is very common after getting off prednisone but not while on it. This could be Avascular Necrosis or IBD related arthritis or something else. I would encourage you to see an Rhuemy and not a regular doctor since your pain level seems to be very high.

Sue

Hi Skidder,

There are extra-intestinal (EI) manifestations of UC, including sacroiliitis, SI, (where sacrum attaches to the big pelvic bone) and anklyosing spondylitis, AS, (in the veterbral joints of the spine). There are also a couple of skin conditions, an eye problem, and a serious liver-gallbladder problem that are far more rare presentations of EI UC disease.

Epidemiological studies indicate that these painful arthritic conditions, SI & AS, can manifest up to 10 years prior to the intestinal manifestation of UC. However, both SI & AS do not cause permanent bony or joint damage as in rheumatoid- and osteo-arthritis. The symptoms of these and other extra-intestinal manifestations may or may not coincide (parallel) with the waxing & waning (flare & remission) symptoms of UC in the bowel.

The only "cure" for UC is complete colectomy (removal of the entire bowel). After colectomy - these extraintestinal symptoms are also cured. From my research of recent medical literature, about 30% of us will eventually (during our entire life-timea) undergo a surgical treatment for UC. For some it is life-saving. For others it is a last choice after a lengthy and exhaustive journey of trying every possible treatment modality and remedy (Rx & OTC, conventional & alternative).

Meanwhile, some of the medications used to reduce UC inflammation in the gut may also help control inflammatory pain symptoms in the joints. Outside of the common arsenal of UC medications - opiates for severe bone pain will also slow down the pooper, thereby controlling two major symptoms that often diminish quality of life.
(Constipation is a common side-effect of opiates. Personality changes, tolerance and physical dependence are some of the less desirable side-effects of opiates.)

UC is a life-long chronic condition. Managing symptoms and side-effects across multiple organ systems becomes an enormous challenge. Many physicians don't read the sub-specialty literature for managing IBD. This leads us through the disconnected patchwork of specialists without gaining a full understanding of the what, why, and how of our own bodies. Consequently, we, the medical consumers, have to be as educated as is possible in order to navigate, negotiate and coordinate our own disease management over our life time.

It was during graduate school in 2006 that I developed UC. Enrollment provided unlimited access to the medical literature via search engines, e.g., Medline. Obsessively I spent uncountable hours searching and reading the literature on UC from every aspect and orientation of relevance. Even as a well-informed health professional, (an RN studying chronic disease management), I've had to negotiate decisions at every encounter with my GI doc. Luckily, my beloved and irreverent PCP, provides second opinions when the GI doc and I don't agree on the treatment plan.

There is a lot of crap on the world wide web. But there are multiple national and international association and health education websites for patients &/or professionals that are reputable and free. There are a few routes to access Medline (and other medical search engines). Many health and related institutions pay for group access, but an individual subscription to medline is exorbitantly expensive. There is some limited access through the NIH & NLM. Some public and college libraries, and patient education centers of your local hospital or health care system may provide access to these specialty search engines.

There are a few excellent patient education books on UC or IBD (UC & Chrones) available. IBD specialists have written these 'home manuals' that cover all the topics that arise over one's life time. Even though my copy is out-dated by 10 years - I go back to it over & over when when concerned about symptoms, or need a refresher on my meds, etc. It's really worth it to own one of these books for the UC patient. It feels like having spent a full week being educated by an IBD specialist.

TMI? Sorry - I don't get out much, and my friends & family get only 'need to know' information. Anyway - hope this is helpful for someone.

Ciao - Denny Rae

Extraintestinal manifestations and complications in
inflammatory bowel diseases

World J Gastroenterol 2006 August 14; 12(30): 4819-4831
http://www.wjgnet.com/1007-9327/12/4819.asp

Several factors may be responsible for extraintestinal
organ involvement in IBD and sometimes it can be
diffi cult to differentiate the true extraintestinal manifestations
(EIMs); i.e. primary systemic affection by the disease itself,
from secondary extraintestinal complications of the disease,
caused for example by malnutrition, chronic infl ammation
or side effects of therapy.

Some of these EIMs may not correlate with disease activity (primary sclerosing
cholangitis and ankylosing spondylitis) but in general EIMs tend to follow the clinical course of IBD and may have a high impact on quality of life, morbidity and even mortality in these patients.

Axial arthropathies
The axial arthropathies are not associated with disease
activity of IBD. Spondylitis occurs in 1%-26% of patients
with IBD and males are more often affected than females.
Both progressive ankylosing spondylitis and sacroiliitis
(sometimes asymptomatic) may occur. Plain radiographs
of the sacroiliac joints show uni- or bilateral sclerosis
and/or erosions. The diagnostic gold standard is magnetic
resonance imaging (MRI) with a high sensitivity in
detecting sacroiliitis even in the absence of symptoms.


Isolated sacroiliitis
It may occur in patients with IBD but most patients
are asymptomatic and the disease is non-progressive.
Prevalence depends on the radiological method used and
varies from 18% in plain radiographs and 32% in CT
imaging to 52% in radioisotope scintigraphy. Isolated
sacroiliitis seems not to be associated with HLA*B27[6].
Asymptomatic HLA*B27 negative patients with normal
spinal mobility do not require specifi c treatment.

Several factors may be responsible for extraintestinal
organ involvement in IBD and sometimes it can be
diffi cult to differentiate the true extraintestinal manifestations
(EIMs); i.e. primary systemic affection by the disease itself,
from secondary extraintestinal complications of the disease,
caused for example by malnutrition, chronic infl ammation
or side effects of therapy. Some of these EIMs may
not correlate with disease activity (primary sclerosing
cholangitis and ankylosing spondylitis) but in general
EIMs tend to follow the clinical course of IBD and may
have a high impact on quality of life, morbidity and even
mortality in these patients.

Denny Rae said...
Hi Skidder,

However, both SI & AS do not cause permanent bony or joint damage as in rheumatoid- and osteo-arthritis.

The only "cure" for UC is complete colectomy (removal of the entire bowel). After colectomy - these extraintestinal symptoms are also cured. From my research of recent medical literature, about 30% of us will eventually (during our entire life-timea) undergo a surgical treatment for UC. For some it is life-saving. For others it is a last choice after a lengthy and exhaustive journey of trying every possible treatment modality and remedy (Rx & OTC, conventional & alternative).Ciao - Denny Rae

wrong - SI and AS always do permanent damage. if this damage is incapacitating or not depends of the severity of the disease.

partialy wrong - after colectomy - AS or SI is not cured - i know a lot of people with colectomy that still strugle with AS. but there is a truth in the fact that the activity of our UC can corelate with the activity of our AS (it's the case for me).