On The Topic of IBD and Spondylitis
9/25/06
An article published in the medical journal, Rheumatology International, discusses the treatment of the arthritic manifestations of inflammatory bowel disease.
The association between IBD, especially Crohn's Disease and ulcerative colitis, and ankylosing spondylitis has been well documented. In his book, "Ankylosing Spondylitis: The Facts", Dr. Muhammad Asim Khan states, "AS patients have an increased frequency of mild gut inflammation, even though they have no obvious inflammatory bowel disease." And that studies indicate that a small percentage of them will "develop clinically obvious Crohn's disease."
In the journal article, the authors outline various treatment regimes. Of particular note are the warnings against using non-steroidal anti-inflammatory drugs (NSAIDs) because they may "induce intestinal ulcerations and can active inflammatory bowel disease." Also, the authors suggest that on the cases of severe spondylitis and IBD that TNF-a inhibitors should be considered as a first line treatment.
Of three TNF-a inhibitors that have been approved for use in treating ankylosing spondylitis, only Remicade (infliximab) has been also approved in treating ulcerative colitis and Crohn's disease.
Traditional treatments include sulfasalazine, which has been shown to help treat the intestinal lesions caused by IBD. Sulfasalazine has also been shown to effectively control pain and joint swelling in the extremeties in people with AS.
References: "The treatment of the rheumatological manifestations of the inflammatory bowel diseases ." Melissa Padovan et al. Rheumatology International; Volume 26, Number 11 / September, 2006; 953-958.
"Ankylosing Spondylitis: The Facts". Dr. Muhammad Asim Kahn. Oxford Press, 2002.