Diseases > Enteropathic Arthritis > What can I do about it?
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The first thing is don’t panic. Take a deep breath. Although you might have been diagnosed with enteropathic arthritis, you are not alone. Luckily, there are effective treatments available. Even if they don’t cure enteropathic arthritis they can make living with the condition much more comfortable.
If you have enteropathic arthritis or think you may have it, your family doctor should refer you to a rheumatologist. You might also need to see a gastroenterologist to help manage your bowel disease.
Here are some recommendations:
- Learn as much as you can about this disease. Knowledge is power and we’ve aimed to develop this RheumInfo website so it’s easy to understand
- Attend your rheumatologist and/or gastroenterologist appointments regularly
- Get your blood tests done as suggested by your doctor
- Learn about the medications used to treat enteropathic arthritis. The RheumInfo website has many interactive and valuable tools to help you understand these medications and their impact on your disease
Treatment of Enteropathic Arthritis
The earlier you treat enteropathic arthritis, the better. An early diagnosis and treatment will help control the inflammation that might be responsible for body aches and pain. It is important to manage your bowel disease and keep it under control. Treatment for enteropathic arthritis depends on the how the disease has presented, which can be very different for different people.
Medications for Enteropathic Arthritis
For cases of enteropathic arthritis with acute attacks on the peripheral joints (ankles, knees, hips, wrists, elbows) corticosteroids can be very effective to control inflammation. These can be taken orally as pills (prednisone) or sometimes as cortisone injections directly into a joint. This type of treatment can reduce the pain and swelling in joints affected by enteropathic arthritis. It may also provide the quickest relief.
Non-Steroidal Anti-Inflammatory Drugs or NSAIDs are medications that can also be used to reduce the inflammation of joints. They also help to reduce pain. However, for about 1 in 5 patients, NSAIDS can cause flaring of the bowel disease.
If the arthritis is more chronic, Disease Modifying Anti-Rheumatic Drugs (DMARDs) can be effective. Methotrexate, sulfasalazine and azathioprine are common DMARDs used in people with enteropathic arthritis.
In cases where joint pain and stiffness aren’t relieved by anti-inflammatory drugs or DMARDs, there is a newer group of medications called anti-TNF biologics. Examples of anti-TNF biologics used for inflammatory bowel disease include infliximab (Remicade), adalimumab (Humira) and golimumab (Simponi). Anti-TNF biologics are extremely effective. DMARDs and anti-TNF biologics in combination can also be used control IBD.
For cases of enteropathic arthritis with spinal or sacroiliac inflammation, the best options are often NSAIDs and anti-TNF biologics.
Treatment for patients with symptoms similar to fibromyalgia can be the most challenging. Making sure that any inflammation of the bowel is treated is very important and may significantly help symptoms. If there is no active bowel disease then treatments used for people with fibromyalgia can be used to control pain. For more information about these treatments, see the RheumInfo section on fibromyalgia.
For more information about specific medications used to treat enteropathic arthritis, refer to the “pictopamphlets” in the Medications section of this website.
Exercises for Enteropathic Arthritis
For people with enteropathic arthritis, physical therapy and exercise are an important part of treatment. The right exercises can actually improve the pain and stiffness in affected joints. They can also protect the joints by strengthening the muscles around them. You must be careful about the type of exercise and activities you do. It will depend on what joints have been affected and the severity of your disease.
Moderate stretching can help reduce pain and keep joints flexible. Aerobic exercise such as walking, swimming or bicycling works your heart and increases your overall fitness. It is also an important part of keeping a healthy weight. A trained arthritis physiotherapist can help design an exercise program tailored to you and your needs.
Read these useful articles on exercising with arthritis – many of the tips can also be applied to people with enteropathic arthritis:
Natural or Home Remedies for enteropathic arthritis
There are no known natural remedies or complementary therapies that have been proven to help enteropathic arthritis in any significant way. However, it’s important to check with your doctor or rheumatologist to make sure that nothing interacts with your medication if you choose to use natural remedies or complementary therapies.
Diet for enteropathic arthritis
Questions about diet and enteropathic arthritis are very common. We all want to know what we can do to help ourselves. Can we change our diet to improve our immune system and help our condition? Changing our diet gives us a sense of control over a disease which often seems to have a mind of its own.
Unfortunately, there is no standard diet that has been proven to significantly alter the course of enteropathic arthritis. However, certain food triggers can cause IBD to flare. It is important to recognize what foods trigger your bowel disease and avoid them.
Alcohol and enteropathic arthritis
Many of us like to share a glass of wine, a beer or a spirit from time to time. Unfortunately, due to the nature of enteropathic arthritis, some people may turn to alcohol to help cope with the distress. Alcoholic beverages are not an effective treatment for enteropathic arthritis. They can also interact with some of the medications you may be taking.
Smoking and enteropathic arthritis
Cigarette smoking, whether you have enteropathic arthritis or not, has no positive effects on any aspect of your health. Smoking can make some of the medications you are taking less effective. Smoking is also a risk factor for IBD. So, if you are a smoker with enteropathic arthritis, quitting could be one of the best things you can do to improve your overall health.
The symptoms of enteropathic arthritis can be quite varied. For some people, joints can flare at the same time as bowel disease flares. For others, a flare in the joints can be a sign of worsening disease in the bowels. Controlling bowel disease can sometimes improve arthritis symptoms. It can also be the other way around – controlling arthritis can help improve IBD. Collaboration between a rheumatologist and a gastroenterologist can help optimize management of this disease.