Brazilian Natural Medicine

Reactive arthritis: what it is, treatment, symptoms and causes

Reactive arthritis, formerly also known as Reiter’s Syndrome, is an inflammatory disease that develops shortly after or during a bacterial, usually gastrointestinal, infection. Because it happens as a result of an infection, this type of arthritis is called reactive.

Reactive arthritis is composed of the clinical triad: arthritis, urethritis and post-infectious conjunctivitis. This disease is more common in young adults with a history of infection within the last 4 weeks.

In most cases, people diagnosed with reactive arthritis get better after a few months without treatment, but there is a chance it will recur. The treatment for this type of arthritis is established by the general practitioner or rheumatologist according to the symptoms presented by the patient and the cause of the disease, and the use of anti-inflammatory drugs, analgesics, corticosteroids or antibiotics may be recommended.

Causes of reactive arthritis

Reactive arthritis usually arises as a consequence of a urogenital or intestinal bacterial infection. In the case of urogenital infection, it can be due to sexually transmitted diseases, such as chlamydia, for example, which is caused by the bacterium Chlamydia trachomatis. When due to intestinal infections, it may be due to infection by Campylobacter sp, Shigella sp or salmonella spfor example.

These infections can occur because of unprotected intimate contact, in the case of Sexually Transmitted Infections (STIs), they are associated with urethritis or cervicitis, which can be asymptomatic, although in most cases it causes pain and burning when urinating, in addition to urethral or vaginal discharge, or due to food poisoning in the case of intestinal bacterial infections. Also, reactive arthritis can be caused by a viral infection. There are also reports of reactive arthritis following immunotherapy for bladder cancer.

Symptoms of Reactive Arthritis

Reactive arthritis is characterized by a triad of symptoms (arthritis, urethritis and conjunctivitis), that is, the disease shows signs of infection, joint inflammation and eye problems. Thus, the main signs and symptoms related to reactive arthritis are:

  • Symptoms of Infection:

    • Polyuria, which is the production of large amounts of urine during the day;
    • Pain and burning when urinating;
    • Presence of blood in the urine;
    • Urgent urge to urinate;
    • Signs and symptoms related to prostatitis in men, such as difficulty maintaining an erection, pain when ejaculating and presence of blood in the semen;
    • Signs and symptoms related to cervicitis, salpingitis, or vulvovaginitis in women.
  • joint symptomswhich can range from transient monoarthritis to polyarthritis, that is, one or more joints may be involved:
    • Joint pain;
    • Difficulty moving the affected joint;
    • Pain in the lower back;
    • Swelling in the joints;
    • Inflammation of the tendons and ligaments associated with the joint.
  • eye symptoms:
    • Redness in the eyes;
    • excessive tearing;
    • Pain or burning in the bones;
    • Swelling;
    • Burning eyes;
    • Increased sensitivity to light, called photophobia.

In addition, other more general symptoms may also appear, such as excessive tiredness, back pain, fever above 38ºC, weight loss, canker sores, abdominal pain or diarrhea, for example. When these symptoms appear, it is recommended to consult a general practitioner to assess the problem and indicate the need to consult a rheumatologist to initiate appropriate treatment.

Diagnosis of reactive arthritis

The diagnosis of reactive arthritis is basically clinical, in which the doctor assesses whether there are the characteristic signs and symptoms of the triad, that is, the presence of signs and symptoms related to infection, joint inflammation and eye problems.

In addition, the doctor may order a genetic test to be performed to identify HLA-B27, which can be considered a marker that is positive in patients with reactive arthritis. In isolation, HLA-B27 has little diagnostic value and is not indicated in the routine care of these patients.

How is the treatment done?

Treatment for reactive arthritis is done according to the symptoms presented by the person and the cause of the disease, and the rheumatologist usually recommends the use of anti-inflammatory and analgesic drugs, such as Paracetamol or Ibuprofen. In some cases, the use of corticosteroids, such as Prednisolone, may also be recommended to reduce inflammation in various parts of the body and relieve symptoms.

The rheumatologist may also indicate the use of antibiotics, if reactive arthritis is caused by bacterial infection and the body is not able to eliminate the bacteria, however the use of antibiotics has no impact on the development of the disease. In addition, in the event that the joints are affected, physiotherapy may also be indicated, which is done with exercises that help to regain limb movement and relieve pain.

However, it is not always possible to completely relieve all the symptoms of reactive arthritis, and a chronic condition develops that causes the symptoms to recur for a few weeks.

Reactive arthritis remedies

In most cases of reactive arthritis, the doctor indicates the use of non-steroidal anti-inflammatory drugs (NSAIDs) in order to relieve symptoms, and the use of Ibuprofen or Diclofenac may be recommended to reduce pain and facilitate joint movement. In case the use of NSAIDs is not enough, the use of other drugs may be recommended, such as:

  • Corticosteroidssuch as Prednisolone or Betamethasone, to lessen symptoms of inflammation when anti-inflammatories are not enough;
  • antibioticswhich varies according to the infectious agent responsible for the infection and the sensitivity profile of the microorganism.

Treatment for reactive arthritis typically lasts about 6 months, but in some cases it can be as long as 1 year depending on the severity of symptoms and the person’s response to treatment.

Physiotherapy for reactive arthritis

Physiotherapy treatment is important in the treatment of this type of arthritis to avoid stiffening of the joint. In this way, physiotherapy indicates and performs some exercises to relieve joint symptoms, increase range of motion and prevent deformations that can happen as a result of the disease.

Check out the video below for some exercises for arthritis:

Always consult a doctor.

Verified by RJ985 – Brazilian natural medicine

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