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Reactive Arthritis Risk Factors, Prevention And Treatment Options

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Reactive arthritis is characterized by joint pain and swelling that are brought on by an infection in another area of the body, most frequently the genitalia, urinary system, or intestines.

This condition usually affects the knees, ankles, and feet. The skin, eyes, and tubes that drain urine from the body are all susceptible to inflammation (urethra). Reactive arthritis was once known as Reiter's syndrome.

Few cases of reactive arthritis exist. For the majority of people, signs and symptoms arise and vanish over a year.

The joints, eyes, and urinary tract are all impacted by the inflammatory form of arthritis known as reactive arthritis (bladder, vagina, urethra). Inflammation happens when germs enter the bloodstream and trigger your body's response, which results in inflammation in various bodily regions.

Reactive arthritis-causing microorganisms are typically acquired through sexual contact or consuming bad food. Usually, the inflammatory response starts 2 to 4 weeks after infection. While the bacterium that causes reactive arthritis cannot be spread from person to person, reactive arthritis itself is not infectious.

The majority of afflicted men are younger than 40-year-old men. They are nine times more likely than women to get the disease as a result of an STI, according to the evidence. Nonetheless, the likelihood of both sexes contracting the disease is equal. 

Causes

Reactive arthritis arises in response to an infection in your body, frequently in the genitalia, urinary system, or intestines. If the triggering infection only causes minor symptoms or none at all, you might not even be aware of it.

Reactive arthritis can be brought on by several microorganisms. Some are sexually transmitted, while others are foodborne. The most typical ones consist of:

  • Campylobacter
  • Chlamydia
  • Clostridial Difficulties
  • Escherichia coli
  • Salmonella
  • Shigella
  • Yersinia

It is not communicable to have reactive arthritis. Yet, the germs that cause it can be spread through contaminated food or sexual contact. Reactive arthritis is rare among those who are exposed to these germs.

Reactive arthritis has been connected to bacterial infection. The following are most frequently linked to reactive arthritis:

A strain of Chlamydia. Via sexual contact, it is disseminated. Infections can start in the urethra, bladder, or vagina.

Shigella, Yersinia, Campylobacter, and Salmonella. The gastrointestinal system is frequently affected by these microorganisms.

Reactive arthritis can occasionally be brought on by the same bacteria that cause respiratory infections, Chlamydia pneumoniae.

One of these two routes is normal for germs to enter your body:

Urinary tract. During sexual intercourse, bacteria can enter through the vagina or urethra and spread to the bladder.

Stomach and intestines (GI). If you consume rotten food or food that has come into touch with polluted surfaces, bacteria may enter your body.

Those who are not exposed to these microorganisms do not acquire the illness. Yet scientists have discovered a gene known as human leukocyte antigen (HLA) B27 that increases a person's risk of developing reactive arthritis. The illness is not always present in people who inherit this gene.

How to check if you have Reactive Arthritis?

See your doctor if you get joint discomfort within a month of having diarrhoea or a genital infection.

Risk Factors

Reactive arthritis risk factors include the following:

Age. Adults aged 20 to 40 are most likely to have reactive arthritis.

Sex. Reactive arthritis is just as likely to occur in men and women after exposure to foodborne illnesses. Yet, reactive arthritis brought on by germs introduced during intercourse is more common in males than in women.

Inherited traits. Reactive arthritis has been related to a particular genetic signature. However, the majority of those with this marker does not go on to experience the illness.

Symptoms

Reactive arthritis's signs and symptoms often appear 1 to 4 weeks after contracting the infection that causes them. They might consist of:

Stiffness and pain. Knees, ankles, and feet are where reactive arthritis-related joint pain most frequently manifests itself. Besides the buttocks and low back, the heels can also be painful.

Inflamed eyes. Reactive arthritis patients frequently have ocular irritation (conjunctivitis).

Urinary issues. Urination may become more frequent and uncomfortable, and there may be cervicovaginal or prostate gland irritation.

Tendon and ligament inflammation at the point of attachment to the bone (enthesitis). The heels and foot soles are where this occurs the most frequently. In certain instances, toes or fingers may swell to the point that they seem distended.

Skin conditions. Mouth sores, a rash on the soles of the feet, and sores on the palms of the hands are just a few of the skin-related symptoms of reactive arthritis.

A sore back. In general, the discomfort is more severe at night or in the morning.

Reactive arthritis most frequently manifests as the joint, ocular, bladder, and urethral irritation (the tube that helps remove urine from the body). Sometimes, mouth sores and skin rashes might occur.

These are a few potential symptoms broken down by bodily parts.

Joint Complaints

  • Knees, ankles, feet, and occasionally fingers and wrists also experience pain and swelling.
  • Tendinitis, or swelling where the tendons join to the bone (enthesitis).
  • Heel spurs and foot discomfort (bony growths in the heel).
  • Buttock and lower back ache.
  • Inflammation of the lower back, which connects the spine to the pelvis, or of the spine (spondylitis).

Eye Conditions

  • Red eyes.
  • Angular and itchy eyes.
  • The vision is hazy.
  • Several indicators of ocular inflammation may be present.

Signs of the Urine

  • Discomfort when urinating.
  • Require more frequent urination.

The symptoms of reactive arthritis can range in severity from extremely mild and intermittent across weeks to months to more severe. Early on, symptoms might not be apparent. Often, urinary symptoms come on first, however, they might be missing in women. Conjunctivitis may accompany or follow this symptom. Often, arthritis is the last symptom to manifest.

Prevention

You may be more or less prone to develop reactive arthritis depending on genetic variables. While there is no way to alter your genetic makeup, there are steps you may take to lessen your exposure to microorganisms that may cause reactive arthritis.

Keep your food at the right temperature when cooking it. By following these tips, you can reduce your risk of contracting many foodborne pathogens, such as salmonella, shigella, yersinia, and campylobacter, which can lead to reactive arthritis. Reactive arthritis may be brought on by specific sexually transmitted diseases. To help minimize your risk, use condoms.

Treatments

The purpose of therapy is to control your symptoms and maybe still-existing infections.

Medications

If there is evidence of a chronic infection, your doctor may recommend an antibiotic if a bacterial infection caused your reactive arthritis. The type of antibiotic you need depends on the bacteria in question.

Reactive arthritis symptoms and signs may be lessened by:

Medications that are non-steroidal anti-inflammatory (NSAIDs). The inflammation and discomfort of reactive arthritis can be reduced with prescription NSAIDs, such as indomethacin (Indocin).

Steroids. The inflammation in the afflicted joints can be reduced with a steroid injection, allowing you to resume your normal activity level. Eye symptoms may be treated with steroid eye drops, while skin rashes may be treated with steroid creams.

Medicines for rheumatoid arthritis. Evidence shows that some persons with reactive arthritis may benefit from the pain and stiffness relief provided by drugs such as sulfasalazine (Azulfidine), methotrexate (Trexall), or etanercept (Enbrel).

Physical exercise

You can receive specific workouts for your joints and muscles from a physical therapist. By building the muscles around the afflicted joints, strengthening activities boost the joint's support. Exercises that include a range of motion can make your joints more flexible and less tight.

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Page last reviewed: Apr 7, 2023

Next review due: Apr 7, 2025

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