Gastrointestinal Events in Rheumatoid Arthritis: Time for the Lower Gastrointestinal Tract!

Gastrointestinal Manifestations of Rheumatic Diseases

“…Gastropathy associated with NSAID use may direct physicians toward the use of a selective type of NSAIDs known as cyclooxygenase 2 inhibitors (COX-2), which in many trials proven its efficacy in reducing GI complications such as bleeding, perforations, or obstructions. Physicians may use alternative methods for GI protection with NSAID use such as prescribing proton pump inhibitor (PPI) or misoprostol combined with NSAIDs [15,16].…”

“…Surprisingly, RA vasculitis may occur in patients with inactive joint disease. Furthermore, it can complicate with GI bleeding, ulcerations, bowel perforations, and small and large intestine infarctions [10,15]. The prognosis in such patients is commonly poor, and the consequences may be fatal [17].…”

“…Pneumatosis cystoides intestinalis is rarely associated with RA [19]. GI side effects associated with use of NSAIDs do not merely involve the upper GI tract; it also can involve the lower GI tract [15].…”