Ulcerative colitis (UC) is a form of inflammatory bowel disease (IBD). In addition to gastrointestinal symptoms, people with this condition often experience painful and swollen joints.

According to the Crohn's & Colitis Foundation, up to 25% of people with IBD have symptoms of arthritis, which is an inflammation of the joints.

The joint pain that UC causes may have different characteristics than the pain of arthritis without IBD. Doctors may also treat it differently.

In this article, learn about the link between UC and joint pain, including how to manage and treat the pain.

What's the connection?

While most of the common symptoms of UC are gastrointestinal, such as bloating, diarrhea, and bloody stool, this disease can also affect other parts of the body. Joint pain is one of the most common symptoms of UC not related to the stomach and intestines.

Two forms of joint pain may affect people with UC:

• Arthralgia, which is only joint pain. It is a symptom of arthritis.
• Arthritis, a term that covers joint pain, inflammation, swelling, and redness.

People with UC usually have a different experience of arthritis than those with an arthritis diagnosis but no IBD. They may develop it at a younger age but not have long-term joint damage.

Joint pain tends to occur during a UC flare and disappear in periods of remission when other symptoms are under control.

Types of arthritis in people with UC

Several types of arthritis can affect those with UC:

Peripheral arthritis

This form of arthritis affects certain parts of the body, including those below:

• arms
• legs
• elbows
• wrists
• knees
• ankles

The pain may move from one joint to another. It is the most common form of joint pain in people with UC.

The level of inflammation in the joints generally corresponds to the extent of the inflammation in the colon. The symptoms of peripheral arthritis usually disappear without causing long-term damage once UC symptoms are under control.

Axial arthritis

This form of arthritis is also known as spondylitis or spondyloarthropathy, and it causes pain in the lower spine and sacroiliac joints.

Joint pain from axial arthritis may present months or years before a person experiences any UC symptoms.

This condition can lead to parts of the spine fusing, which can decrease a person's range of motion and result in permanent damage.

Ankylosing spondylitis

Ankylosing spondylitis is a more severe form of arthritis, but it is a rare complication of IBD. It is more likely to affect people who have Crohn's disease than those with UC.

Ankylosing spondylitis causes inflammation in the spine and sacroiliac joints. It can also affect the lungs, eyes, and heart valves.

It usually develops in people with a genetic predisposition to bowel or urinary tract infections and tends to appear before the age of 30 years.

Symptoms can cause long-term damage, and a person may require surgical removal of the colon.

Treatment and management

It is essential that people visit a rheumatologist for a proper diagnosis so they can get the best treatment and learn techniques for managing their symptoms.

People with peripheral arthritis but without UC can usually control pain and swelling with nonsteroidal anti-inflammatory drugs, such as ibuprofen or aspirin.

However, doctors do not usually recommend these medications to people with UC because they can irritate and further inflame the intestines.

Instead, the following medications may be necessary to control both the joint and intestinal inflammation and pain:

• steroids
• immune-suppressing drugs
• disease-modifying antirheumatic drugs
• biologic drugs

Biologic drugs can also treat axial arthritis and ankylosis spondylitis.

In addition to medical treatments, people can try home remedies to help alleviate pain. These include:

• using heating pads
• applying a warm, wet compress
• stretching and doing range-of-motion exercises
• icing painful areas of the body
• elevating the affected joint

Reducing arthritis risk

People with UC can reduce their risk of arthritis and joint pain by:

• Eating a healthful diet. A registered dietitian can help create a suitable anti-inflammatory diet plan.
• Avoiding certain foods. It is best to limit or avoid foods that may aggravate UC symptoms, such as dairy products and high-fiber, high-fat, or spicy foods.
• Lowering stress levels. Limiting exposure to stressful situations, seeing a therapist, and learning relaxation techniques, such as meditation, may help.
• Taking medication as a doctor has prescribed.

Takeaway

UC is a form of IBD. Along with gastrointestinal symptoms, it can cause painful and swollen joints.

The level of joint pain in people with UC often correlates with the extent of the intestinal inflammation. Any inflammation of the joints does not usually result in long-term damage.

A doctor can provide advice on treating both UC and any associated joint pain.