Common musculoskeletal conditions among those with inflammatory bowel disease – arthritis and fibromyalgia
Three observations suggest that we might be looking at a single underlying mechanism of disease.
1. 25% of those with inflammatory bowel disease (IBD) develop symptoms or disease that does not directly affect the intestinal tract. This is a very high percentage.
2. These symptoms can occur before or at the same times as the IBD – not just after it. This suggests that whatever is causing the IBD is also causing the other symptoms or disease – not simply that IBD causes the other manifestations.
3. The severity of IBD and the other manifestations seem to move in parallel.
A fourth observation – that controlling the IBD controls the related symptoms/disease could be taken to mean either that the IBD causes the other symptoms/disease, so controlling IBD controls the other symptoms/disease, or that in treating IBD we are simultaneously treating the other conditions.
According to one theory, most of these inflammation-related disease conditions spring from a common underlying dysfunction of the immune system – primarily its inability to turn off. Since treatment for IBD is primarily directed against inflammation, the findings observed in this publication are consistent with that theory.
Of particular interest is that fibromyalgia is one condition that manifests as a result of, or with, IBD. There is some debate over whether fibromyalgia is related to inflammation and, if so, to what extent.
The publication:
nflamm Bowel Dis. 2009 Apr 30;15(12):1915-1924. [Epub ahead of print]
Musculoskeletal manifestations of inflammatory bowel disease.
Bourikas LA, Papadakis KA.
Summary of the abstract
Extraintestinal manifestations develop in approximately 25% of patients with inflammatory bowel disease (IBD).
Musculoskeletal symptoms are the most common extraintestinal manifestations of IBD, often associated with colonic involvement, and present as either arthritis or fibromyalgia.
Musculoskeletal manifestations can precede or be synchronous with the development of bowel disease or develop following the diagnosis of IBD. Their clinical course often correlates with IBD activity but it can also be independent of the activity of bowel disease.
Controlling intestinal inflammation remains the cornerstone therapeutic approach for the musculoskeletal manifestations of IBD.
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