Saturday, March 10, 2012

Diarrhea, urine infection, colds and arthritis: Any connection?

Could that have been just another cold and sore throat?

Was that just a mild diarrhea you had?

Well, some of these common infections can be followed by pain in the heel, swelling and pain of the ankles and knees, red eyes and some weird skin rash. This arthritis that follows a common cold, or a passing diarrhea, or infection in the urine, can be what is known as reactive arthritis (ReA). This condition is more common among young individuals, more in males, and can involve inflammation not just in the joints but also in the eyes and skin.

Infections cause arthritis in several ways:
  1. infectious arthritis - bacteria from infections found in other parts of the body like decayed tooth, infected gums and sinuses, skin, urinary tract etc., find their way into the joints through the blood circulation
  2. reactive arthritis - prior infection causes inflammation of joints, without bacteria actually growing in the joint. This can be associated with inflammation of the eyes and skin.
    • common sources
      • urinary tract infection
      • diarrhea due to specific bacterai like yersinia and shigella
      • strep infection of the throat or the "strep throat"
  3. infection-associated arthritis - when arthritis is part of the disease, though uncommon, the following diseases can include arthritis as part of the general presentation of the disease
    • hepatitis and other viral infections
Arthritis that arise from infections, whether infection in the joint per se, or as a reactive process, require specialty treatment.
  1. Infectious arthritis is a rheumatologic "emergency" and needs to be seen by an orthopedic surgeon or a rheumatologist.
  2. Reactive arthritis, likewise needs to be recognized fast, since the disease can be very disabling and recognizing its self- limiting nature is therefore very important. It can have a prolonged course and needs to be treated appropriately to avoid disability. A rheumatologist is the best doctor to consult for these types of arthritis.

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