Rheumatoid Arthritis and Your Digestive System


Chris Iliades, MD

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Man clutching stomach

If you're living with rheumatoid arthritis (RA), you may be familiar with symptoms of joint pain and stiffness. You may also be experiencing gastrointestinal (GI) symptoms. Many studies show that GI symptoms are common when you have RA. Your GI system has an upper and lower section, and RA can affect both of them. The upper GI system runs from your mouth, to where your stomach empties into your small intestine. The lower GI system is all of your small and large intestines.

A study published in the Journal of Rheumatology followed 813 people with RA and 813 people without RA for about 10 years. Those with RA had a 70% greater chance of having an upper GI problem and a 50% greater chance of having a lower GI problem, compared to people who didn't have RA.

Symptoms of Upper and Lower GI Problems

A study published in the journal Gastroenterology Research and Practice compared 284 people with RA to 233 people without RA, asking all of them to answer questions about upper and lower GI symptoms. The study found that upper GI symptoms like stomach pain, feeling full after meals, and nausea were more common in people with RA than people without RA. They also found that people with RA took more laxatives and more proton pump inhibitors, which are drugs that blocks stomach acid.

Here are some of the GI problems you may have with RA:

  • An ulcer or perforation (hole) in your stomach, small intestine, or large intestine

  • Swelling of your esophagus (swallowing tube)

  • Infection and swelling of your small or large intestine

These problems can produce symptoms that include:

  • Trouble swallowing

  • Heartburn

  • Belly pain

  • Indigestion

  • Black, tarry stools (due to upper GI bleeding)

  • Constipation

  • Bloody stools (due to lower GI bleeding)

  • Leaking of stool

Watch: Managing RA With Lifestyle