It has long been recognized that rheumatoid arthritis patients have an increased risk of upper gastrointestinal complications, such as bleeding and ulcers. A Mayo Clinic study, published online April 1, 2012 in The Journal of Rheumatology, indicates that rheumatoid arthritis patients are also at increased risk for bleeding and ulcers in the lower gastrointestinal tract, especially the colon.
Adjustments to treatment, such as lowering the dose and duration of nonsteroidal anti-inflammatory drugs (NSAIDs) and corticosteroids, actually have been associated with a decrease in upper gastrointestinal complications. But, the focus has shifted to lower gastrointestinal complications.
In the study, lower gastrointestinal problems were linked to smoking, the use of corticosteroids, a history of upper gastrointestinal complications, and abdominal surgery. Using data from the Rochester Epidemiology Project (1980-2008), Mayo Clinic researchers identified 813 patients with rheumatoid arthritis and 813 without the disease. The incidence of upper gastrointestinal problems in rheumatoid arthritis patients, though still higher than among people without rheumatoid arthritis, declined over the years. The data revealed that the incidence of lower gastrointestinal complications was also higher for people with rheumatoid arthritis than those without the disease. Of the arthritis patients in the study, 229 died and their deaths were significantly associated with gastrointestinal problems, including bleeds, perforation, and obstruction.
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