Enteropathic spondyloarthritis

The inflammatory bowel diseases are chronic idiopathic inflammatory diseases of the gastrointestinal tract that may be complicated by a variety of extraintestinal manifestations such as primary sclerosing cholangitis, erythema nodosum, pyoderma gangrenosum, acute anterior uveitis, and aortic insufficiency. However, rheumatological manifestations are the most common with spondyloarthritis being the most prevalent one. Enteropathic spondyloarthritis can present before, be synchronous with, or after the diagnosis of inflammatory bowel disease with two subsets of joint involvement: axial and peripheral. It is believed that genetic, immunological and environmental factors play a crucial role in the development of enteropathic spondyloarthritis. Although the association between extraintestinal manifestations of symptoms coupled with inflammatory bowel disease have been recognized from before, the exact pathogenic mechanism and link between articular and gut involvement is still largely unknown. Functional studies in this particular field are still needed to understand the complex immune mechanism for these interrelated conditions in the future. Early recognition of enteropathic spondyloarthritis in inflammatory bowel disease patients requires a multidisciplinary approach in order to guide therapy, reduce morbidity, prevent future disability and to improve the quality of life in the affected patients