Post-Infectious Reactive Arthritis
Reactive arthritis (or “RA”) can be caused by recent ingestion of a foodborne pathogen that causes gastroenteritis. These cases of RA are called post-infectious RA because they are caused by the original infection. While rare, happening in less than 5% of the population, RA can be much worse than the initial illness and have life-long consequences.
RA causes joint pain and swelling that is triggered by an infection in a different part of the body, such as the intestines, genitals or urinary tract. RA can present in many ways but tends to targets the joints in a person’s knees, ankles, and feet. RA inflammation can also cause serious swelling or inflammation in the eyes, skin, and urethra. While it can come and go in a matter of months, it can also be a life-long condition and require a great deal of medical treatment.
Closely linked to reactive arthritis is Reiter’s syndrome, which also affects the eyes, urethra, and can impact knees, elbows, shoulders and ankles.
Can Food Poisoning Cause RA?
The underlying reaction that leads to reactive arthritis remains a matter of medical investigation and studies that are going on around the country. There is some evidence, however, that certain persons are more genetically predisposed to acquiring RA, and in fact, as many as 75% of those who suffer RA have tested positive for a genetic marker called HLA-B27.
There is much more certainty about the likely causes of RA, with strong correlations between RA and sexually transmitted diseases such as Chlamydia trachomatis or Ureaplasma urealyticum. In the food poisoning field, most victims of RA get it following gastrointestinal illness secondary to shigella, E. coli, salmonella, yersinia, cyclsospora, or campylobacter bacteria.
There is no way to protect against RA caused by gastrointestinal illness except not to get food poisoning in the first place.
Where does RA Strike Most?
RA begins to manifest itself in the one to four weeks following the causative illness, such as Salmonella. The target zones include:
- Visible signs include sores or rashes on the soles, palms of the hand (called Keratoderma blennorrhagica), or ulcers in the mouth;
- Knees, ankles, and joints in the feet, along with back pain and some pain in the heels and even toes;
- Elbow pain, finger swelling or pain, and arm joint pain;
- Reactive arthritis is also highly correlated with inflammation in the eye, a dangerous condition called conjunctivitis;
- Inflammation of the prostate gland and the cervix can lead to a number of problems, including urgency;
- RA can also lead to muscles, tendons and ligaments pain (often diagnosed as enthesitis.
Do Doctors Diagnose a Person with RA?
Doctors often fail to diagnose RA because of the diffuse symptoms and often focus on a very narrow diagnosis of the symptom they are treating, such as knee pain. Doctors are often not looking for a condition caused by food poisoning after the person has recovered from the direct gastrointestinal symptoms associated with food poisoning. A GI is most likely going to make the link, but input from a patient is vital, especially those who have read up on RA because they can then put the illness they are experiencing into context for the physician or medical treater.
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