Managing Gastrointestinal Issues With Psoriatic Arthritis

Anyone with psoriatic arthritis (PsA) knows how uncomfortable and challenging it can be to live with pain, swelling, and stiffness in the joints. But for some, that pain extends to the gut. People with PsA may experience a range of gastrointestinal (GI) issues.^1,2

Why do GI issues occur?

It comes down to inflammation. PsA stems from an abnormal immune response in the body. This response leads to inflammation in the skin and joints, and sometimes the intestines as well.¹

Recent research has found that people with PsA and psoriasis are 1 to 4 times more likely to have inflammatory bowel disease (IBD) than people without PsA or psoriasis. Psoriasis is the skin condition linked to PsA. IBD involves chronic inflammation in different parts of the digestive tract.^1-3

Conditions that fall under the IBD umbrella include:³

• Ulcerative colitis – inflammation of the lining of the colon and rectum
• Crohn’s disease – inflammation of the digestive tract

What are the symptoms?

People who have IBD along with PsA may have a range of symptoms, such as:³

• Abdominal pain
• Cramping
• Bowel habit changes
• Diarrhea
• Appetite changes
• Weight loss

What is the link between PsA and IBD?

An increasing amount of research has been dedicated to understanding the connection between PsA and IBD. While there is no clear-cut answer, many theories point toward genetics being the underlying issue.^1,4

Genetic mutations that affect inflammation and the immune system may be the reason why certain people have chronic inflammatory conditions like PsA and IBD.^1,4

The gut microbiome may also play a role. The gut microbiome is the unique mix of bacteria in each person's GI tract. Recent research shows that the same microbes that are missing in people with IBD are also missing in people with PsA.^1,4

Dealing with GI symptoms

Here are some ways people with PsA can deal with GI issues:^5,6

• See a gastroenterologist. See a doctor who specializes in GI issues if you are having any stomach pain that does not go away. They can help diagnose your GI problems and decide if they are related to your PsA.
• Try an anti-inflammatory diet. What you eat can make a big difference in avoiding uncomfortable GI symptoms. Eating a diet that is rich in vegetables, fruits, healthy fats, and lean protein may help.
• Avoid trigger foods. Certain foods can trigger uncomfortable symptoms. Keep a food diary to figure out which foods to avoid.
• Consider taking biologics. Biologics are drugs that can help reduce inflammation throughout the body. Examples are adalimumab, certolizumab pegol, golimumab, and infliximab.
• Other medicines can also help. Antidiarrheals and antibiotics are often prescribed for people with IBD during a symptom flare. Your doctor can help you decide which medications are right for you.
• Do not smoke. Smoking can worsen PsA symptoms. It also raises your risk of getting Crohn’s disease. If you do smoke, take steps to quit.
• Manage stress. Stress can make PsA and IBD symptoms worse. Breathing techniques, meditation, and exercise can help reduce stress.

While one treatment may work for you, the same may not work for another person. Talk to your doctor if you have PsA and are experiencing GI issues. They can create a treatment plan that is right for you and your unique symptoms.