A while ago I wrote about arthritis and tummy troubles in a post about the FODMAP plan. People with arthritis often struggle with digestive concerns and these can make it even harder to eat a healthy diet. In fact, there is some evidence to suggest that having arthritis makes you much more likely to have gastrointestinal problems - whether you have osteoarthritis or inflammatory arthritis. To try to help untangle some facts and fictions, I've put together a list of the most common conditions that affect people with arthritis alongside advice on treatment and diet. I'm definitely not a doctor so do make sure you tell yours if you are having any stomach symptoms. You can also find some general info about all of these conditions here.
IBS - irritable bowel syndrome encompasses all sorts of digestive concerns, from bloating and gas to diarrhoea and constipation. It's exact cause isn't understood and it affects different people in different ways. Some studies have suggested that genetic regulation of inflammatory factors may have a role, and the same pattern of genes has been found in some patients with inflammatory arthritis so there may be a link between the two conditions. However, there isn't any evidence that I could find to suggest that IBS is more common in people with these types of arthritis. IBS is strongly associated with a type of arthritis known as fibromylagia. Use of non-steroidal anti-inflammatory drugs (like aspirin or naproxen) has been found to be a risk factor for developing IBS by some researchers, but it is unclear whether this is due to the drugs causing IBS or whether people who take anti-inflammatories may have other conditions or symptoms that are perhaps related to IBS.
IBS is difficult to treat as it has many different causes. A dietician will be able to help you identify your possible triggers and adjust your diet to help. The FODMAP diet has shown great success in treating patients and you can read my post about it here (alongside a cracking chocolate chip cookie recipe). You may also want to see a doctor as there are many medications available to help relieve symptoms.
Coeliac disease - is an auto-immune disease where the body attacks the digestive system in response to exposure to gluten. Gluten is found in wheat, barley, rye and sufferers need to cut it out of their diets entirely. Coeliac disease is not the same as an intolerance or allergy. People with autoimmune, inflammatory arthritis are more likely than the general population to have coeliac disease, and likewise people with coeliac disease are more likely to develop arthritis.
The only treatment is to completely cut out gluten under medical supervision.Some patients are able to tolerate oats, but this varies from person to person. If you suspect you might be coeliac, you must see a doctor to help make the diagnosis before cutting out gluten for the tests to work properly. For more info see Coeliac UK's website and my gluten-free recipes.
Dyspepsia/heartburn/acid-reflux - the enemy of many of an arthritis sufferer, often as a side-effect of steroids, osteoarthritis treatments and anti-inflammatories. High dose NSAIDs have been found to increase the risk of dyspepsia by over 30%. It's important to see your doctor if you have any symptoms of dyspepsia, especially unintended weight-loss, vomiting, difficulty swallowing or blood in your stools.
Taking your arthritis medications with food will help avoid problems. Ginger can help relieve some of the discomfort or try eating probiotic yoghurt. Spicy, fatty and heavy meals can all make it worse.
IBD - inflammatory bowel disease is the term used to describe Crohn's and colitis. Both conditions are auto-immune in origin and cause inflammation in the gastro-intestinal tract. Symptoms include stomach pain, blood and mucus in stools, nausea and weight loss. Spondyloarthropathies (ankylosing spondylitis and psoriatic arthritis) are closely related to IBD, and some patients with IBD will develop arthritis.
Patients with IBD need to be under the care of a gastroenterologist. A dietician can help with any diet plans. Reducing the amount of fibre you eat during a flare by eating well cooked, easily digestible foods can help. There is mixed evidence about the effectiveness of omega 3 fatty acids. When the condition is in remission it is important to eat a healthy, balanced diet and the arthritis-friendly recipes on this site can help you achieve this.