当你有溃疡性结肠炎（UC）时，腹部疼痛正常，以及腹泻和其他胃肠道（GI）症状。

Up to 30 percentof people with UC also have arthritis, which is characterized by swollen, painful joints.

Here’s a look at the connection between UC and joint pain, as well as what you can do to protect your joints if you have UC.

UC是一种炎症性肠病（IBD）。关节炎是IBD中最常见的非GI态组并发症。链接的原因可能位于使IBD更容易受关节炎的人的基因。

Two types of conditions can affect the joints of people with UC. Arthritis is joint pain with inflammation (swelling and redness). Arthralgia is pain in the joints without any inflammation.

Arthritis that occurs with UC is a bit different than regular arthritis. For one thing, it typically starts at a younger age.

In addition, arthritis in people with UC doesn’t usually cause long-term joint damage. The joints swell up and become painful, but they return to normal once intestinal inflammation is under control.

A few types of arthritis can affect people with UC:

外周脊椎关节炎

外周脊椎关节炎is a type of spondyloarthritis (SpA). Spondyloarthritis refers to a group of inflammatory conditions that affect the spine and other joints.

外周脊椎炎接触臂和腿部的大关节，例如：

  • knees
  • ankles
  • 腕子
  • 肩膀
  • 肘部

疼痛水平倾向于镜像你的UC症状。你的UC越严重，关节炎症状越严重。一旦你的肠道症状消失，你的关节疼痛和肿胀也应该消失。

Axial spondyloarthritis (axSpA)

轴向脊椎炎（AxSPA）是一种影响骨盆中下脊柱和骶髂关节的水疗中心。

症状可以在UC诊断前开始几个月甚至几年。AxSPA可能导致脊柱的骨头融合在一起，限制了你的运动。

强直性脊柱炎（AS）

强直性脊柱炎（AS）is a more severe form of axSpA. It can affect your flexibility by making your back stiff and forcing you into a bent-over posture. This type of arthritis doesn’t improve when you treat UC symptoms.

治疗医生建议将取决于您拥有的关节疼痛的类型。

Medications to avoid

People usually control peripheral spondyloarthritis pain and swelling with nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Motrin, Advil) or naproxen (Aleve, Naprosyn).

These drugs can irritate the intestines and make inflammation worse, so they’re not usually a good option for people with UC.

试图的药物

Instead, your doctor might prescribe one of theseUC drugs，它在关节和肠中带来炎症：

  • 类固醇，如泼尼松
  • 疾病修饰的抗胃酸药物（DMARDS），如苏氟碱（氮氟胺）和甲氨蝶呤
  • tofacitinib (Xeljanz), a unique oral medication that reduces inflammation in people with UC
  • injectable biologics, such as adalimumab (Humira), golimumab (Simponi), infliximab (Remicade), and vedolizumab (Entyvio)

Tofacitinib是一类称为Janus激酶（JAK）抑制剂的药物。它还用于减少类风湿性关节炎和银屑病关节炎的炎症。

生物药物也可以治疗AxSPA。如果您有更严重的水疗中心，重要的是坚持治疗医生规定，以防止永久性联合损害。

如果你有中度至重度溃疡性结肠炎

In 2020, theAmerican Gastroenterological Association (AGA)发布了适度至严重UC的成年人的更新的治疗指南。

AGA建议在他们之前应该只接受生物学的人，如果他们是临床研究或登记研究的一部分，只能接受Tofacitinib。

本组织还建议在选择英夫利昔单抗（炼热）或vedolizumab（entyvio）之前从未接受生物学的人，而不是Adalimumab（Humira）。

Adalimumab不像其他两个生物有效logics. However, people with UC can administer adalimumab to themselves, while healthcare professionals have to administer infliximab and vedolizumab. If you’re looking for convenience over efficacy, it’s fine to choose adalimumab instead.

Home remedies

除了服药外，您还可以尝试使用这些家庭疗法管理关节疼痛：

  • Apply warm, wet compresses or a heating pad to achy joints.
  • Stretch the affected joints and do range-of-motion exercises. A physical therapist can show you the correct techniques.
  • 冰并升高发炎或肿胀的关节。

Remember to speak with your doctor before trying any home remedies.

你可能需要风湿病学者的帮助来治疗你的关节疼痛。风湿病学是关节炎专家。医生会提出关于你的痛苦的问题，例如：

  • When did the joint pain start?
  • What does it feel like?
  • 是什么让它变得更好或更糟？
  • Do you have swelling in the joints?

提前一周或两个人保持诊所。这可以帮助您准备您的预约。此外，创建一个您想问您的医生的问题清单。

您的医生将执行一些测试，以了解您是否具有关节炎或其他影响您的关节的条件。这些测试可以包括：

  • 用于IBD和关节炎常见的炎症或基因标记的血液试验
  • a joint fluid analysis
  • an MRI scan
  • X射线

一旦您的GI症状受到控制，关节痛和外周脊椎关节炎疼痛通常应该消失。对于AxSPA，您需要服用生物药物以控制炎症，疼痛和肿胀。

Here are some things you can do that may help prevent joint pain:

  • Take your medications exactly as your doctor prescribed, and don’t skip doses.
  • Follow a balanced diet.如果您需要帮助计划营养餐，请向医生询问指南。
  • 避免加重你的UC的食物。这可能包括辛辣，高纤维，高脂或乳制品。
  • 练习放松技术，如深呼吸，减少你的压力，这可以触发UC爆发。

用西班牙语阅读本文。