How Is Inflammatory Bowel Disease Linked to PsA?

People with psoriatic arthritis (PsA) have an increased prevalence and risk of inflammatory bowel diseases (IBD), including Crohn’s disease and ulcerative colitis. Both PsA and IBD are associated with an abnormal immune response, causing excess inflammation in the body. While the inflammation is most noticeable in the joints in people with PsA, inflammation is also present throughout the body (systemic), which may increase the risk of IBD.1-3 In addition, IBD and PsA share similar genetic mutations.4

Crohn’s disease

Crohn’s disease causes inflammation of the digestive system, affecting areas from the mouth to the anus. It often affects the lower part of the small intestine, the ileum. The cause of Crohn’s disease is unknown, but there is a genetic component with a high incidence in those with a family history of the condition. It most commonly starts between the ages of 13 and 30. Crohn’s disease can cause bleeding from the rectum, weight loss, fever, and complications such as intestinal blockages, ulcers in the intestines, and malnourishment. There is no cure for Crohn’s disease. Treatment can help manage symptoms, and the disease can include periods of remission.3

Ulcerative colitis

Ulcerative colitis causes inflammation and ulcers in the lining of the rectum and colon. It can occur at any age but most often begins between the ages of 15 and 30. Ulcerative colitis tends to run in families, suggesting a genetic component. The most common symptoms are abdominal pain and blood or pus in diarrhea. Severe cases may require surgery to remove the colon. Treatment can help control symptoms, and some people experience long periods of remission.3

Ways to reduce risk

Treatment of IBD and PsA is critical to reducing the risk of long-term complications in both diseases. In PsA, treatment can slow or prevent the potential joint damage, deformity, and disability.5 In IBD, treatment can induce and/or maintain remission, improving the individual’s quality of life and help avoid the risk of surgery and long-term complications.6

Therapies used to treat IBD may overlap with medications that are used to treat PsA. Some common treatments that are used for both conditions include the biologics infliximab (Remicade), adalimumab (Humira), golimumab (Simponi), and certolizumab pegol (Cimzia).1

There are no clear guidelines or data to assess the appropriate treatment for people with both IBD and PsA. In addition, no guidelines exist regarding the use of non-steroidal anti-inflammatory drugs (NSAIDs) in people with PsA and IBD, as it is unclear whether NSAID may exacerbate IBD symptoms.1

Written by: Emily Downward | Last reviewed: October 2016.
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