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Crohn's arthritis unbearable but lack of labs...need advise!!

I am new here and looking for answers because even with all the best intentions in the world doctors just dont have enough answers. I was first diagnosed Jan 2012 (originally 2004 but diagnosis retracted and symtoms disappeared until 2011) . Started with mild joint pain in elbow april 2011 and by June 2011 full on diarrhea with blood in stool, looked like I was hemorraging for 2 weeks. Bloody stool stopped but diarrhea continued as many as 15 times per day. Had episode where I broke out in rash on hand (red itchy painfull spots) two days later followed by joint pain all over body (interesting side note, I woke up one day a couple years earlier with red spots all over knees and elbows that cleared after a week or two and did not happen again and few months later a rash on lower abdomen that looked like a large staph infection according to primary doc). In August 2011 saw a primary that gave me meds for joint pain, mentioned the chronic diarrhea but he had no idea and sent me to a rheumatologist.

After explaining all the systems to the rheumatologist he insisted I first meet with a gastrologist. The rheumatologist diagnosed Ankyolosing Spondalitis but a few months later said he was not sure of his diagnosis. Finally after several months of colonoscopy/biopsies of the colon etc several pathologists agreed with the diagnosis of Crohns with no blockage or displasia. Several months later finally start Humira 40mg 2X per month after trying several DMARD's. The diarrhea is better and MR Enterography shows earlier inflamation gone or at least not detectable according to radiologist but I still have bouts every couple weeks lasting several days at a time and one serious episode of bloody diarrhea for two days about one month ago.

Although the diarrhea has improved significantly I continue to have joint pain in the back and hips every day and bouts of severe joint and muscle pain (seems to coinside with the bouts of diarrhea) in hands, elbow, knees and feet, however all labs come back normal for CRP, Sed Rate etc. It would mean a lot to have a definitive diagnosis on the joint pain, it is really interfering with quality of life, pain meds help but not the permanant answer (prednisone really helped before but could not tolerate side affects). Is it possible to continue with normal labs (labs done 3 times for this) but have the joint pain continue like this? Anyone with knowledge in this area please help!!
 
Hello sorry to hear you are suffering joint pain is really hard to deal with.
I would see about going back to your rheumatologist now that you have the crohn's diagnosis as enteropathic arthritis is caused by IBD. They would be the best people to speak to about a treatment plan for this pain as well.
I have this type of arthritis and the pain gets so bad that I am not able to walk with pain and swelling of joints but my crp only rises slightly. I am currently on methotrexate and the rheumatologist added sulfasalazine to help with joint pain it seems to be ok so far. I have also had steroid injections into the joint and just a general steroid injection, I find this is better as it works quickly (about 2 days) and I didn't notice any side affects.
You shouldn't have to suffer with joint pain I hope you are able to find something that helps soon. X
 

SarahBear

Moderator
Location
Charleston,
Welcome to the forum!

I honestly don't know much about joint pain and Crohn's, but you might want to check out the arthritis section of the EIM forum, here.

I hope you find answers and start to feel better soon!
 

David

Co-Founder
Location
Naples, Florida
Hi there and welcome to the community.

Arthritis is one of the most common extraintestinal manifestations of Crohn's disease. Sometimes the medications can help and I'm all for that, but I'm also a big fan of looking at what Crohn's disease causes when it comes to vitamin and mineral deficiencies. Two BIG ones are vitamin D and magnesium deficiencies. And deficiencies in those can cause all sorts of bone, join, and muscle pain.

Vitamin D deficiency can easily be tested for and I suggest you do so.

The problem with magnesium deficiency is it's hard to detect with a blood test because the body does everything in its power to maintain a static amount in the blood, to the point of robbing it from bone. It is VERY hard to get enough magnesium in a typical western diet, it is absorbed primarily in the terminal ileum where many with Crohn's have active disease, AND it is lost in higher amounts with diarrhea. People with Crohn's really have little chance of proper levels.

I'm a big fan of juicing to get magnesium levels up. Supplementation split across the morning and evening can help as well.

If you are indeed deficient in vitamin D and magnesium then proper supplementation probably won't get rid of your symptoms entirely, but I'd bet good money that it would help a LOT over time.

Again, welcome to the community.
 
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