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Effects and impact of Rheumatoid arthritis

Sowmya T

Guest Lecturer

Department of Zoology

Govt. First Grade College, Tumakuru

Email: sowmyat9049@gmail.com

Ph No: 9481448915

 

Abstract

Rheumatoid arthritis (RA) is an autoimmune disease and it’s also known as chronic inflammatory disorder that can affect more than joints. In some people, the condition can damage a wide variety of body systems, including the skin, eyes, lungs, heart and blood vessels. In this article I have discussed about cause, effect, treatment and symptoms of the oldest disease RA.

Keywords: Rheumatoid arthritis, chronic inflammatory disorder, anti-cyclic citrullinated peptide, antirheumatic drugs, leflunomide (Arava), hydroxychloroquine (Plaquenil) and sulfasalazine (Azulfidine).

Introduction:

            Rheumatoid arthritis (RA) is an autoimmune disease and it’s also known as chronic inflammatory disorder that can affect more than joints. In some people, the condition can damage a wide variety of body systems, including the skin, eyes, lungs, heart and blood vessels.

The joint damage that RA causes usually happens on both sides of the body. So if a joint is affected in one of your arms or legs, the same joint in the other arm or leg will probably be affected, too. This is one way that doctors distinguish RA from other form of arthritis such as osteoarthritis (OA)

An autoimmune disorder, rheumatoid arthritis occurs when your immune system mistakenly attacks your own body's tissues.

.Rheumatoid arthritis Causes & symptoms:

Causes:

Scientist do not know exactly why people get Rheumatoid arthritis’ but they believe that Rheumatoid arthritis occurs when your immune system attacks the synovium — the lining of the membranes that surround your joints.

The resulting inflammation thickens the synovium, which can eventually destroy the cartilage and bone within the joint. The tendons and ligaments that hold the joint together weaken and stretch. Gradually, the joint loses its shape and alignment.

Doctors don't know what starts this process, although a genetic component appears likely. While your genes don't actually cause rheumatoid arthritis, they can make you more susceptible to environmental factors — such as infection with certain viruses and bacteria — that may trigger the disease.

Symptoms

           

RA is a long-term or chronic disease marked by symptoms of inflammation and pain in the joints. These symptoms and signs occur during periods known as flares or exacerbations. Other times are known as periods of remission — this is when symptoms stop completely.

 

Signs and symptoms of rheumatoid arthritis may include:

  • Tender, warm, swollen joints
  • Joint stiffness that is usually worse in the mornings and after inactivity
  • Fatigue, fever and loss of appetite

Early rheumatoid arthritis tends to affect your smaller joints first — particularly the joints that attach your fingers to your hands and your toes to your feet.

As the disease progresses, symptoms often spread to the wrists, knees, ankles, elbows, hips and shoulders. In most cases, symptoms occur in the same joints on both sides of your body.

About 40 percent of the people who have rheumatoid arthritis also experience signs and symptoms that don't involve the joints. Rheumatoid arthritis can affect many non joint structures, including:

  • Skin
  • Eyes
  • Lungs
  • Heart
  • Kidneys
  • Salivary glands
  • Nerve tissue
  • Bone marrow
  • Blood vessels

Symptoms can vary from mild to severe. It’s important not to ignore any symptoms, even if they come and go. Knowing the early signs of RA will helps doctors to treat it better.

 

Rheumatoid arthritis diagnosis

            Rheumatoid arthritis can be difficult to diagnose in its early stages because the early signs and symptoms mimic those of many other diseases. There is no one blood test or physical finding to confirm the diagnosis.

During the physical exam, doctor will ask about patient symptoms and medical history. They’ll also perform a physical exam of  joints. This will include:

  • Looking for swelling and redness
  • Testing your reflexes and muscle strength
  • Touching the affected joints to check for warmth and tenderness

If they suspect RA, they’ll most likely refer the patient to a specialist called a rheumatologist..

Since no single test can confirm a diagnosis of RA, doctor or rheumatologist may use several different types of tests.

 

Blood Test: People with rheumatoid arthritis often have an elevated erythrocyte sedimentation rate (ESR, or sed rate) or C-reactive protein (CRP), which may indicate the presence of an inflammatory process in the body. Other common blood tests look for rheumatoid factor and anti-cyclic citrullinated peptide (anti-CCP) antibodies.

Imaging tests: Your doctor may recommend X-rays to help track the progression of rheumatoid arthritis in your joints over time. MRI and ultrasound tests can help your doctor judge the severity of the disease in your body.

Treatment: There is no cure for rheumatoid arthritis. But clinical studies indicate that remission of symptoms is more likely when treatment begins early with medications known as disease-modifying antirheumatic drugs (DMARDs).

Medications: The types of medications recommended by doctor will depend on the severity of symptoms and how long patient had rheumatoid arthritis.

  • NSAIDs. Non-steroidal anti-inflammatory drugs (NSAIDs) can relieve pain and reduce inflammation. Over-the-counter NSAIDs include ibuprofen (Advil, Motrin IB) and naproxen sodium (Aleve). Stronger NSAIDs are available by prescription. Side effects may include stomach irritation, heart problems and kidney damage.
  • Steroids. Corticosteroid medications, such as prednisone, reduce inflammation and pain and slow joint damage. Side effects may include thinning of bones, weight gain and diabetes. Doctors often prescribe a corticosteroid to relieve acute symptoms, with the goal of gradually tapering off the medication.
  • Disease-modifying antirheumatic drugs (DMARDs). These drugs can slow the progression of rheumatoid arthritis and save the joints and other tissues from permanent damage. Common DMARDs include methotrexate (Trexall, Otrexup, others), leflunomide (Arava), hydroxychloroquine (Plaquenil) and sulfasalazine (Azulfidine).

Side effects vary but may include liver damage, bone marrow suppression and severe lung infections.

Therapy: Doctor may send patient to a physical or occupational therapist who can teach exercises to help keep  joints flexible. The therapist may also suggest new ways to do daily tasks, which will be easier on joints. For example, patient may want to pick up an object using your forearms.

Assistive devices can make it easier to avoid stressing painful joints. For instance, a kitchen knife equipped with a hand grip helps protect finger and wrist joints. Certain tools, such as buttonhooks, can make it easier to get dressed

Surgery: If medications fail to prevent or slow joint damage, then doctor may consider surgery to repair damaged joints. Surgery may help restore patient ability to use  joint. It can also reduce pain and improve function.

Rheumatoid arthritis surgery may involve one or more of the following procedures:

  • Synovectomy. Surgery to remove the inflamed lining of the joint (synovium) can be performed on knees, elbows, wrists, fingers and hips.
  • Tendon repair. Inflammation and joint damage may cause tendons around joint to loosen or rupture. surgeon may be able to repair the tendons around joint.
  • Joint fusion. Surgically fusing a joint may be recommended to stabilize or realign a joint and for pain relief when a joint replacement isn't an option.
  • Total joint replacement. During joint replacement surgery, surgeon removes the damaged parts of your joint and inserts a prosthesis made of metal and plastic.

Home remedies for rheumatoid arthritis

Certain home remedies and lifestyle adjustments may help to improve quality of life when living with RA. This includes exercises, rest, and assistive devices.

Exercise: Low impact exercises can help to improve the range of motion in joints and increase mobility. Exercise can also strengthen muscles, which can help to relieve some of the pressure from  joints. gentle yoga which can help regain strength and flexibility.

Get enough rest: Patient may need more rest during flare-ups and less during remission. Getting enough sleep will help to reduce inflammation and pain as well as fatigue.

Apply heat or cold: Ice packs or cold compresses can help to reduce inflammation and pain. They may also be effective against muscle spasms.

Assistive devices: Certain devices such as splints and braces can hold joints in a resting position. This may help to reduce inflammation.

Canes and crutches can help maintain mobility, even during flares. You can also install household devices, such as grab bars and handrails in bathrooms and along staircases.

 

Rheumatoid arthritis diet: Doctor or dietitian may recommend an anti-inflammatory diet to help with symptoms. This type of diet includes foods that have lots of omega-3 fatty acids.

Foods high in omega-3 fatty acids include: fatty fishes like salmon, tuna, herring, and mackerel, chia seeds,flax seeds, walnuts, Antioxidants, such as vitamins A, C, and E, and selenium, may also help reduce inflammation.

Food high in antioxidants include: Berries, such as blueberries, cranberries, goji berries, and strawberries, dark chocolate, spinach Kidney beans, pecans, artichokes

Eating lots of fiber is also important, because according to some researchers, fiber may help reduce inflammatory responses which may decrease C-reactive protein levels. Choose whole grain foods, millets, fresh vegetables, and fresh fruit. Strawberries may be particularly beneficial.

Foods containing flavonoids can also help to counter inflammation in the body. They include:

soy products, such as tofu and miso, berries, green tea, broccoli, grapes

What you don’t eat is just as important as what you do eat. Make sure to avoid trigger foods. These include processed carbohydrates and saturated or trans fats.

Avoiding trigger foods and choosing the right foods to follow an anti-inflammatory diet may help you manage your RA.

Risk factors

Factors that may increase risk of rheumatoid arthritis include:

  • Sex. Women are more likely than men to develop rheumatoid arthritis.
  • Age. Rheumatoid arthritis can occur at any age, but it most commonly begins in middle age.
  • Family history. If a member of family has rheumatoid arthritis, may have an increased risk of the disease.
  • Smoking. Cigarette smoking increases risk of developing rheumatoid arthritis, particularly if you have a genetic predisposition for developing the disease. Smoking also appears to be associated with greater disease severity.
  • Environmental exposures. Although poorly understood, some exposures such as asbestos or silica may increase the risk of developing rheumatoid arthritis. Emergency workers exposed to dust are at higher risk of autoimmune diseases such as rheumatoid arthritis.
  • Obesity. People - especially women age 55 and younger - who are overweight or obese appear to be at a somewhat higher risk of developing rheumatoid arthritis.

Complications: Rheumatoid arthritis increases risk of developing:

  • Osteoporosis. Rheumatoid arthritis itself, along with some medications used for treating rheumatoid arthritis, can increase risk of osteoporosis — a condition that weakens your bones and makes them more prone to fracture.
  • Rheumatoid nodules. These firm bumps of tissue most commonly form around pressure points, such as the elbows. However, these nodules can form anywhere in the body, including the lungs.
  • Dry eyes and mouth. People who have rheumatoid arthritis are much more likely to experience Sjogren's syndrome, a disorder that decreases the amount of moisture in eyes and mouth.
  • Infections. The disease itself and many of the medications used to combat rheumatoid arthritis can impair the immune system, leading to increased infections.
  • Abnormal body composition. The proportion of fat to lean mass is often higher in people who have rheumatoid arthritis, even in people who have a normal body mass index (BMI).
  • Carpal tunnel syndrome. If rheumatoid arthritis affects wrists, the inflammation can compress the nerve that serves most of in hand and fingers.
  • Heart problems. Rheumatoid arthritis can increase risk of hardened and blocked arteries, as well as inflammation of the sac that encloses heart.
  • Lung disease. People with rheumatoid arthritis have an increased risk of inflammation and scarring of the lung tissues, which can lead to progressive shortness of breath.
  • Lymphoma. Rheumatoid arthritis increases the risk of lymphoma, a group of blood cancers that develop in the lymph system.

The difference between rheumatoid arthritis and osteoarthritis

Like RA, people with osteoarthritis (OA) can experience painful and stiff joints that make moving around difficult. People with OA may have joint swelling after extended activity, but OA doesn’t cause any significant inflammatory reaction that typically results in redness of the affected joints. Unlike RA, OA isn’t an autoimmune disease. It’s related to the natural wear and tear of the joints as you age, or it can develop as a result of trauma. OA is most often seen in older adults. However, it can sometimes be seen in younger adults who overuse a particular joint - such as tennis players and other athletes — or those who’ve experienced a severe injury.

RA is an autoimmune disease. The joint damage from RA isn’t caused by normal wear and tear but by their own body attacking itself. 

Concussion

            Rheumatoid arthritis is seems to be oldest disease but earlier it was miss-understood that it’s osteoarthritis but recent research work & technologies helped us to differentiate the rheumatoid arthritis and osteoarthritis. Rheumatoid arthritis know as a chronic disease but early identification and regular treatment can cure this ill but it is again depends on individual response to medicine otherwise it won’t kill us but it make patient disabled person, further un-treated for long term it make cause death also. Along with medicine life style and food habit may impact more  

Reference

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