Arthritis is the most common non-intestinal condition associated with Crohn’s Disease and Ulcerative Colitis. Although most people with these diseases do not develop arthritis, three primary kinds may develop:
- Rheumatoid-like Arthritis: This usually involves the wrists and fingers and may improve or worsen without regard to the course of the bowel disease. Sometimes people with this form of arthritis have an antibody in the blood called rheumatoid factor but not all people with rheumatoid-like arthritis have this antibody.
- Ankylosing Spondylitis: This is a condition that involves the lower of the spine and adjacent joints. In addition to pain, it may cause stiffening of the spine, hips, neck, jaw and rib cage. Its course is independent of the underlying bowel disease. As time goes on, the condition may develop even after the bowel disease has improved or the bowel has been removed.
- Large Joint Arthritis: This usually affects the knees, ankles, hips and occasionally the elbows and shoulders. The small joints of the hands, feet and spine are usually not involved. Unlike other kinds of arthritis this form often worsens as the bowel disease worsens, and improves as the disease improves. This type of arthritis does not leave permanent joint deformities.
We do not know what causes these three forms of arthritis that develop with either Crohns or UC. Many physicians have attributed the arthritis to some immunologic process that may accompany the intestinal disease but evidence for this is still lacking.