Rheumatoid Arthritis Increases Risk of Lower GI Events

October 18, 2009
Bradley Schmidt

Though researchers continue to investigate exactly why, data indicates RA increases an individual's risk of lower GI bleeding or perforation, diverticulitis, lower GI ulcers, and appendicitis.

This Mayo Clinic poster session was quite popular with attendees, who likely took interest because lower GI complications in RA are much less studied than upper GI events, of which there is strong evidence in RA patients.

Researchers examined two cohorts—RA and non-RA—of a patient population based in Olmsted County, Minnesota, all of whom were first diagnosed between 1980 and 1998.

“We analyzed incidence data from medical records and found that lower GI events are more likely to occur in patients with RA,” says Dr. Elena Mayasoedova of the Mayo Clinic. “These events include lower GI bleeding or perforation, diverticulitis, lower GI ulcers, and appendicitis.”

Data indicated that RA patients are also at an increased risk for surgical interventions (especially for bowel obstructions) and hospitalizations (diverticular disease, GI bleeding or perforation, and infectious colitis,) for lower GI events.

Despite these findings, the fact that researchers conducted an observational study prevented them from drawing hard conclusions about pathogenesis, but do suspect that RA severity and medications are viable culprits.

Mayasoedova does caution that most patients in this study were diagnosed before the introduction and widespread use of biologics, and because follow up was ongoing for 14 years, it is possible that biologics were introduced into therapy at some point. “For this reason we couldn’t exclude the impact of biologics and seek to further analyze the correlation between drugs, medications, and incidents of lower GI in our further studies.”