They are at greater risk for GI problems and gastrointestinal-related death than people without the disease, a Mayo Clinic study shows. Researchers say their findings point out the need for new ways to prevent and treat lower GI disease in rheumatoid arthritis patients; the incidence of lower gastrointestinal complications is rising even as upper GI problems decrease significantly among rheumatoid arthritis patients.
Smoking, the use of steroids known as glucocorticoids, prior upper GI disease and abdominal surgery were associated with lower GI problems in rheumatoid arthritis patients, the study found. The research was published online this week in The Journal of Rheumatology.
Rheumatologists have long recognized that rheumatoid arthritis patients are at higher risk for upper GI problems such as stomach ulcers and bleeding. The study suggests increased awareness of that and likely, modern treatment strategies that emphasize the need to prevent ulcers and bleeding and control rheumatoid arthritis without relying as much on nonsteroidal drugs and corticosteroids have reduced upper GI complications, says co-author Eric Matteson, M.D., Chair of the Department of Rheumatology at Mayo Clinic in Rochester.
"What we are also seeing for the first time in a systematic way is that patients with rheumatoid arthritis also are at risk for problems of bleeding and ulcers in the lower gut, especially the colon," Dr. Matteson says.
Lung disease, heart problems, osteoporosis and carpal tunnel syndrome are among other potential complications for patients with rheumatoid arthritis, an often debilitating disorder in which the immune system attacks tissues, inflaming joints. To study the incidence of GI problems in rheumatoid arthritis patients, Mayo researchers identified 813 patients with rheumatoid arthritis and 813 without it, using data from 1980-2008 in the Rochester Epidemiology Project, a National Institutes of Health-supported effort in which Mayo and other Olmsted County, Minn., health care providers pool medical records.
The incidence of upper GI problems in rheumatoid arthritis patients declined over the years but was still higher in that group: 2.9 for every 100 person years compared with 1.7 in non-rheumatoid arthritis patients. The rate of lower GI problems in rheumatoid arthritis patients was 2.1, compared with 1.4 in others, the study found. Of the arthritis patients studied, 229 died. GI problems were significantly associated with their deaths, including bleeds, perforations and obstructions.
"Our findings emphasize that physicians and patients must be vigilant for these complications, which can occur without causing abdominal pain," Dr. Matteson says. "Especially stopping smoking and reducing the use of corticosteroids would appear to be important in reducing the risk of major lower GI complications."
The study co-authors are biostatistician Cynthia Crowson; gastroenterologist Nicholas Talley, M.D., Ph.D.; and Elena Myasoedova, M.D., Ph.D., all of Mayo Clinic.
About Mayo Clinic
Mayo Clinic is a nonprofit worldwide leader in medical care, research and education for people from all walks of life. For more information, visit http://www.mayoclinic.org/about and www.mayoclinic.org/news
Sharon Theimer | EurekAlert!
Unique brain 'fingerprint' can predict drug effectiveness
11.07.2018 | McGill University
Direct conversion of non-neuronal cells into nerve cells
03.07.2018 | Universitätsmedizin der Johannes Gutenberg-Universität Mainz
For the first time ever, scientists have determined the cosmic origin of highest-energy neutrinos. A research group led by IceCube scientist Elisa Resconi, spokesperson of the Collaborative Research Center SFB1258 at the Technical University of Munich (TUM), provides an important piece of evidence that the particles detected by the IceCube neutrino telescope at the South Pole originate from a galaxy four billion light-years away from Earth.
To rule out other origins with certainty, the team led by neutrino physicist Elisa Resconi from the Technical University of Munich and multi-wavelength...
For the first time a team of researchers have discovered two different phases of magnetic skyrmions in a single material. Physicists of the Technical Universities of Munich and Dresden and the University of Cologne can now better study and understand the properties of these magnetic structures, which are important for both basic research and applications.
Whirlpools are an everyday experience in a bath tub: When the water is drained a circular vortex is formed. Typically, such whirls are rather stable. Similar...
Physicists working with Roland Wester at the University of Innsbruck have investigated if and how chemical reactions can be influenced by targeted vibrational excitation of the reactants. They were able to demonstrate that excitation with a laser beam does not affect the efficiency of a chemical exchange reaction and that the excited molecular group acts only as a spectator in the reaction.
A frequently used reaction in organic chemistry is nucleophilic substitution. It plays, for example, an important role in in the synthesis of new chemical...
Optical spectroscopy allows investigating the energy structure and dynamic properties of complex quantum systems. Researchers from the University of Würzburg present two new approaches of coherent two-dimensional spectroscopy.
"Put an excitation into the system and observe how it evolves." According to physicist Professor Tobias Brixner, this is the credo of optical spectroscopy....
Ultra-short, high-intensity X-ray flashes open the door to the foundations of chemical reactions. Free-electron lasers generate these kinds of pulses, but there is a catch: the pulses vary in duration and energy. An international research team has now presented a solution: Using a ring of 16 detectors and a circularly polarized laser beam, they can determine both factors with attosecond accuracy.
Free-electron lasers (FELs) generate extremely short and intense X-ray flashes. Researchers can use these flashes to resolve structures with diameters on the...
13.07.2018 | Event News
12.07.2018 | Event News
03.07.2018 | Event News
16.07.2018 | Physics and Astronomy
16.07.2018 | Life Sciences
16.07.2018 | Earth Sciences