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Gastrointestinal Events Linked to Rheumatic Diseases

According to Medpage Today, in an April issue of Annals of the Rheumatic Diseases, researchers from the University of Zaragosa School of Medicine in Spain found that the incidence rate of any GI adverse event was 19 per 100 person- years during 6 months’ follow-up of patients with osteoarthritis, rheumatoid arthritis (RA), or ankylosing spondylitis. The study also reported that symptomatic uncomplicated gastrointestinal events, such as dyspepsia, nausea, and vomiting, had a rate of 18.5 per 100 person-years, and for complicated events, such as hemorrhage or perforated ulcers, the rate was 0.7 per 100. Notably, the occurrence of GI events was higher than in previous non-interventional studies. Rheumatologist Dr. Susan Baker comments on these findings concerning the lives of people affected by rheumatic diseases. “Rheumatic diseases cause so many health complications because of their widespread effects,” said Beverly Hills rheumatologist Susan Baker, MD. “While specific parts of the body may experience the most symptoms, these conditions may be quietly causing major issues in other parts of the body.”

In rheumatic diseases, the immune systems attacks the body’s own tissues and can cause significant harm to the gastrointestinal tract. Gastrointestinal events are often influenced by the pathophysiologic characteristics of the underlying disease process. There are a wide variety of gastrointestinal events stemming from rheumatic diseases, including oral ulcers, dysphagia, gastroesophageal reflux disease, abdominal pain, constipation, diarrhea, fecal incontinence, pseudo-obstruction, perforation and gastrointestinal bleeding. While non-steroidal anti-inflammatory drugs, or NSAID’s, can help, the benefits of NSAIDs may be offset by an increased risk of dyspepsia, other abdominal symptoms, cardiovascular events, and serious gastrointestinal complications such as peptic ulcer.

“While certain treatments may aid in rheumatic conditions, negative effects on the gastrointestinal system can mean an overall worse health,” said Dr. Baker. “Every patient needs to balance his or her needs with the possible side effects.”

GI events connected with NSAID treatment can occur without warning and therefore significantly increase the risk of these agents. NSAID’s can cause minor side effects like abdominal pain and vomiting, or major side effects like ulcers and bleeding. Researchers conducted a study known as EVIDENCE that incorporated 4,144 patients from 363 centers in 12 different countries. Each participant enrolled had at least one risk factor for GI events. One in four patients had two risk factors, and one in 10 had three or more, therefore classifying them as high risk. The study’s overall endpoint was the frequency of symptomatic uncomplicated or complicated GI events of both the upper and lower GI tract. Additional endpoints included the incidence of GI events for patients receiving or not receiving proton pump inhibitors and the incidence of cardiovascular and other events.

“Every patient affected by rheumatic conditions needs to consult with a skilled rheumatologist. Only through an approach that takes a person’s entire health into consideration can a patient find a healthier life,” said Dr. Baker.

Dr. Susan Baker is board certified in both internal medicine and rheumatology. She has been providing exceptional and personalized care from her Beverly Hills facility since 2003. She is also a teacher and clinical instructor at Cedars Sinai Hospital and UCLA, David Geffen School of Medicine, respectively.

To learn more about Susan A. Baker MD, Rheumatology & Internal Medicine, please visit, or call (310) 274-7770.

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