reactive arthritis -salmonella poisioning
F75. Previously healthy, mobile. I got salmonella poisoning at a breakfast place. Confirmed. 5 weeks later I started to hurt all over.. No history of arthritis. Confirmed as reactive arthritis-only 3 sources- HIV/AIDs, IBS, food borne illness. Mine from the latter. Confirmed by Infectious Disease Specialist. Rheumatologist prescribed Celebrex. One pill and violently ill. Now taking Advil. Not helpful. PCP has no clue what to do next and rheumatologist seems uninterested! Trying to do medical research [used to be called Reiter's]. Has anyone had it or had it treated successfully?
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What did they treat you with?
Gigi
Antibiotics wipe out the trigger for RA, but one is left with the inflammatory arthritis. NSAIDs (like Advil) made it worse for me (and my GI tract), maybe because they are rather puny anti-inflammatory meds for RA. The corticosteroids had little or no effect. Methotrexate was the last try and worked because it suppressed my immune system from attacking me. My rheumatologist would switch me to a new med as soon as he found out the current was wasn't working or I had an adverse effect. The treatment for RA has evolved since I had it. PCPs don't usually have much background in RA; specialists are best. I think doctors start with the more passive treatment because some cases of RA inflammation fade away after a few months (not in my case). If you don't mind incredibly boring reading NIH and ResearchGate have good papers. https://www.nhs.uk/conditions/reactive-arthritis/treatment/#:~:text=When%20you%20first%20start%20getting,movement%20in%20your%20affected%20joints.
The abbreviation of Reactive Arthritis is (ReA) so it won't be confused with Rheumatoid Arthritis (RA). I only know this because a poor resident doctor reported to my staff rheumatologist that I had a "history of RA." The staff rheumatologist pounced and said that wasn't true. There was an awkward silence until I said I had reactive arthritis (ReA).
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ReA falls under the umbrella of a "family of disorders" known as Spondyloarthritis. There are several types of Spondyloarthritis but they all have similar characteristics. There isn't much research that is done specifically for the treatment of ReA. In part, this is because of its association with Dr. Reiter.
I think the general guidelines are to treat the offending infection first if the infection hasn't already resolved. NSAIDs come next and if that isn't enough, then methotrexate is added.
https://rheumatology.org/patients/spondyloarthritis
Collectively, chronic and recurring forms of spondyloarthritis are treated with TNF inhibitors. I always had a flare of uveitis that would accompany my reactive arthritis flares. My ophthalmologist used high dose Prednisone-- usually 60 mg to start followed by a fast taper. That kind of dose of Prednisone alleviates almost any kind of inflammation and pain.
After more than 30 flares of uveitis in 20 years, my ophthalmologist referred me to a "uveitis specialist" who said I should have been referred to her a long time ago. She recommended Humira, a TNF-inhibitor so as to prevent the flares from recurring so often.
You might want to read the China Study by T. Collin Campbell. A Whole Foods plant based diet. Eliminate all animal foods. Has been a lifesaver for me.
I was going to recommend you as our resident source for first hand experience and a medical pro to boot.
For others - my son had it in his 20’s after knee surgery and again in his 40’s after a cervical surgery. His system apparently does not like joint invasion!
"His system apparently does not like joint invasion!"
My initial flare of reactive arthritis (ReA) was probably an enteric infection. There is a theory that remnants of whatever organism causes ReA may "hide" in the tissues surrounding large joints like the knees and the joints of the spine. Anything that "stirs up" the joints can cause the remnants of the organism to be exposed. The immune system senses the infection is still present and starts to attack the joints again. The joints are victims of collateral damage as the immune system attempts to rid the body of the recurring infection.
Another theory is the structure of the offending organism is chemical similar to the tissues surrounding the joints. The immune system has a hard time distinguishing the organism from the body's own tissues and attacks both.
I don't know if either theory is true but they were interesting to me.
Both of my knees were replaced and I had an "aberrant healing process" after my knee replacements. The orthopedic surgeon said I shouldn't ever have surgery again because of "heterotopic ossification."
Heterotopic ossification (HO) is a condition where bone grows in soft tissue or muscles, instead of in the skeleton. It can occur after an injury, such as a spinal cord injury or musculoskeletal trauma, or for no known reason.
HO is bone growth where bone doesn't belong. The surgeon doesn't want to remove the extra bone because the "invasive nature of the procedure" could cause more abnormal bone growth and make the problem even worse.
My son had infection associated with both surgeries - years apart and unrelated. The knee infection took a bit of wit to get rid of and initially the team of docs evaluating his systemic reactive arthritis thought it was a reaction to meds. Got the right diagnosis and some prednisone and all was well.
The post surgical cervical infection was much more serious because as it turned out, it was hiding out on top of an artificial disc - which of course has no blood supply so is unresponsive to antibiotics. They kept giving stronger and stronger antibiotics until he had a near fatal anaphylactic reaction. They went in to undo the artificial disc and found massive infection - they rinsed and rinsed and rinsed and then it was shortly ok. But the reactive arthritis was not so quick to resolve. His was the case of the year in the hospital’s M&M meetings 🙂
Cellebrex. 1 tab and ibfelt liked been given a tab of acid.
1 month of Alleve and my kidneys trashed. Nothing now!
Neen going on now since June. Question please. I am i going to recover? Or is this it for the rest of my life? Genuinely scared.
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Finally got in! Had an infectious disease specialist say once you completed the 7 day antibiotic course for the initial offending problem leaves your system completely. Your theory that bits of it hides and returns when it gets stirred up makes more sense! Cite?