Rheumatoid Arthritis and Irritable Bowel Syndrome: Does RA Start In The Gut?

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Rheumatoid arthritis (also referred to by its acronym, RA) is, as anyone who has it will tell you, a painfully debilitating condition that takes a serious toll on the joints according to Mayo Clinic.

Not only does it impact the joints, but it can cause damage to other organs and tissues found throughout the body, including the lungs, heart, blood vessels, eyes, and the skin.

It seems to also be inextricably connected to gut health. Many individuals who are diagnosed with RA (or with other autoimmune disorders) have co-occurring gastrointestinal (GI) issues.

In fact, it appears that this baffling co-morbidity occurs more often than not. In other words, if you have RA, there is probably a good chance that you currently have or will develop GI problems.

That begs the question of “How are RA and GI issues linked and can either be cured?” The answer is, as indicated below, complex, but those with RA and GI should know that it is possible to reverse the severity of symptoms.

What Exactly Causes Rheumatoid Arthritis?

Rheumatoid arthritis (RA) is a type of chronic inflammatory disease (as well as an autoimmune disorder) which is most highly characterized by inflammation around the joints.

It tends to be most noticeable in the hands but can occur in any of the joints found throughout the body.

Unlike osteoarthritis, RA inflicts its damage to the synovium (which is a type of lining) around your joints, causing the surrounding ligaments and tendons to wear down.

Over time, this degeneration can result in serious loss of bone density and deformity of the joints themselves.

Additionally, because it is an autoimmune disease, having RA means that your body is attacking itself by mistake.

As Dr. Ana-Maria Orbai writes, autoimmune diseases arise as a result of your body being unable to tell the difference between which cells are yours and which are foreign invaders.

Essentially, your autoimmune system creates an overactive response and ends up attacking your healthy cells as if they were harmful invaders (such as a virus).

Scientists are still uncertain as to what causes autoimmune diseases like RA to manifest.

There does appear to be a strong genetic component, as RA tends to be passed along through bloodlines.

Although having a blood relative with RA can put you at risk for also having it, this is not a solid guarantee that you will develop signs of RA.

There are a few other risk factors for RA that you should be aware of. RA tends to be most predominant in women and typically manifests when a woman is between 40 and 60 years of age.

Your environment and lifestyle choices can also factor into the equation, especially when it comes to obesity and smoking habits.

What Is Causing My Irritable Bowel Syndrome?

According to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), Irritable Bowel Syndrome (or IBS for short) is not one singular symptom but a complex grouping of symptoms, many of which can occur together.

A lot of people think of IBS as being just an ongoing case of upset stomach, but the truth is that IBS is the result of serious changes occurring within your gastrointestinal tract.

Like RA and other autoimmune disorders (which can also co-occur with IBS), the underlying cause of IBS is not yet scientifically known. However, researchers and doctors speculate that multiple things can cause IBS.

Some of the most commonly-reported issues that seem to cause IBS to include stress, anxiety, depression, intolerance or sensitivity to certain foods, bacterial infections, and an overabundance of unhealthy bacteria in the small intestine.

Again, as with autoimmune diseases, some individuals seem to be genetically predisposed to IBS.

The key to figuring out what is causing your IBS is to focus on the foods that you consume.

While there is no hard-and-fast medical test for this, you can attempt to undergo a gut detoxification process with the help of a trained nutritionist.

As Choung and Talley state, numerous studies on those who do diet eliminations and challenges have shown that the removal of trigger foods can improve IBS symptoms.

Some of the foods known to be culprits behind IBS symptoms include wheat, dairy, fried food, hot spices, caffeinated beverages, and gluten.

Many of those who have RA also have these food intolerances, and some choose to cut these foods from their diets in order to help decrease inflammation.

How Is RA Connected With IBS?

As you can probably discern from reading the last few sections, there is a pretty strong connection between RA and IBS. But what exactly is that connection, and why is it so common? The answers might surprise you.

According to the Arthritis Foundation, there are multiple studies out there that indicate that high levels of bodily inflammation are responsible for causing RA and IBS symptoms.

Inflammation can be caused by several factors, ranging from the food you eat to the high-stress lifestyles we tend to live.

Additionally, approximately 20 to 30% of individuals with RA also develop Fibromyalgia, a condition which results in chronic, widespread pain and includes IBS symptoms.

The most important thing to know about inflammation is that it exists in a vicious cycle. While symptoms might seem to start in one area of your body (for example, in your GI tract), the inflammatory cytokines that get activated spread throughout your entire body.

As Dr. Kelly Brogan asserts, these cytokines are responsible for inflicting damage from oxidative stress on your mitochondria and bodily tissues.

Inflammation of the upper GI tract (stemming from the mouth to the end of your stomach) can cause tearing in the stomach’s lining, ulcers, bleeding, and irritation in your esophagus.

This tends to be a common issue in RA patients who have been prescribed non-steroid anti-inflammatory drugs (NSAIDs) for extended periods of time.

Meanwhile, problems in the lower GI tract (in other words, the large and small intestines) include colitis (which is swelling that occurs in the large intestine) and diverticulitis (inflammation in the sacs which surround your intestines).

Another culprit behind RA inflammation and gut issues is Candida albicans. According to Lisa Richards, Candida – an overgrowth of fungus – wreaks havoc on the immune system.

Multiple studies conducted in recent years have shown that Candida is responsible for causing inflammation in the gut as well as various tissues throughout the body. More specifically, Candida impacts the production of pro-inflammatory TH17 cells and their interleukin, IL-17.

How Healing The Gut Helps To Treat RA Symptoms

So, where does the healing process begin? The answer might not be one that is easy to accept and enact, but it is crucial to consider. According to 4AHealthyGut Website, Changing your diet and exercise habits is a great way to kick-start the process of reversing your symptoms.

As Clint Paddison (a chronic RA patient and founder of the Paddison Program) discusses in this video, figuring out which food sensitivities and allergies might be causing inflammation is important in shaping your RA-friendly diet.

There are specific foods which appear to cause gut inflammation almost across the board and are foods you should consider removing from your diet.

Foods containing gluten, wheat, and dairy products tend to be the biggest triggers of bodily inflammation and GI issues.

Various types of meat (especially fattier meats) can also cause problems. While you should consider removing these foods from your diet, you do not have to remove them all right away.

Incrementally deleting these foods can help ease you into your diet, and you might also learn along the way that you react poorly to foods you would not have suspected could cause such problems, such as foods high in histamines.

Exercise is also an important element of your healing process. Even milder forms of RA can make exercise feel painful and exhausting.

However, in order to combat RA, you need to move your body. The key is finding the types of exercise that increase joint and muscle flexibility and get your blood circulating throughout your entire body.

Many individuals with RA have found that doing water exercises on a routine basis encourages greater mobility in their joints.

Joint tenderness, swelling, and pain seem to decrease for many people with activities like water aerobics and regular swimming sessions.

Also, quite a few studies have found that practicing yoga provides many benefits for those coping with symptoms of RA and other autoimmune diseases.

Yoga is low-impact, so you will not have to worry about incurring additional damage to your joints.

Even the most basic yoga poses can yield major results by providing muscle tone, flexibility, and developing that crucial core strength.

Practicing yoga for just 15 minutes to half an hour a couple of times per week can decrease inflammation and help you feel stronger and more energized.

Yoga also comes with the added perk of providing many people with inner relaxation through meditated breathing.

Walking is another form of exercise that doctors tend to recommend to their RA patients.

Starting off at a slow-but-steady pace in a place where you feel secure, you can start to develop strength in your legs and pelvic area.

Wearing supportive shoes and staying hydrated while you walk is important, and as you do more walking, you will likely notice yourself feeling more energized and less inflamed.

What Are My Treatment Options?

Aside from lifestyle and dietary changes, there are additional treatment options that can help you decrease your RA inflammation. Some doctors will prescribe you with corticosteroids, disease-modifying antirheumatic drugs (DMARDs), biologics, or Janus kinase (JAK) inhibitors.

For more chronic cases, surgery might be necessary to repair damaged joints, but it is often the last resort for doctors and their patients.

There are quite a few herbs and natural supplements on the market that are known for their anti-inflammatory properties.

Turmeric is, according to the Arthritis Foundation, is one of the herbs most commonly used to treat stiffness and inflammation in RA patients.

It has a long history in Ayurvedic medicine, as it has long been known to clear excess mucus and aid in the healing of wounds. It can easily be included in meals and mixes well with ginger in herbal teas.

Probiotics are another potential source of healing, especially when it comes to your gut. Probiotics help by introducing billions of healthy bacteria into your gut, which then work to flush out unhealthy gut microbiota that is known to cause inflammation when they accumulate.

Probiotics can come in kefir and yogurt, but if you have histamine or lactose intolerance, you will need to consider avoiding those sources.

Instead, you can opt for non-dairy forms of yogurt and kefir or purchase over-the-counter probiotics from your local drug store.

Is There a Cure For RA or IBS?

Unfortunately, there is no known cure for RA or IBS. While scientists are still working to uncover the root source of these conditions, it appears that the best hope for living a healthy and functional life is to make the important changes to your diet and exercise routine. Discovering what might be triggering inflammation in your gut is a major step in the healing process.

Another step that you might wish to consider taking is becoming active in RA support groups. This not only provides you with opportunities to learn more about RA and how to combat it, but it also invites you to participate in a network of emotional support from others who understand your struggles.

Find people with RA who have already made major lifestyle changes or who are willing to become your accountability partners throughout your healing journey.

Rheumatoid arthritis and irritable bowel syndrome are a common co-morbidity that team up to make life a little bit more painful.

While there is still no known medical cure, you can begin to reclaim your health by removing inflammatory foods from your diet and finding the right exercises that help to increase flexibility in your joints while decreasing inflammation.

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