Enteropathic Arthropathy

There seems to be a connection between the gut and spondyloarthropathies. Of patients with inflammatory bowel disease (IBD; ulcerative colitis and Cohn's disease), 10% to 20% have a peripheral arthritis different from other defined arthritides. Migratory arthralgias, especially of the knees, ankles, and feet, often coincide with periods of GI disease flares. Other joints, including the spine and sacroiliac joints, might be involved but are seemingly less coincident with bowel exacerbations. HLA-B27 is found in 50% of patients with IBD-associated spondylitis but is not found in a higher percentage than in the general population for this type of spondylitis. RF and ANA are negative. NSAIDs are normally used but must be taken with caution given the patient's underlying GI disease. As noted earlier, dietary factors might increase the patient's baseline inflammatory state, so a trial of dietary manipulation or the addition of omega-3 fatty acids is reasonable.

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