Living with Psoriatic Arthritis (PsA)

Wondering About Irritable Bowel Syndrome now


Hi again,

Another day, another question, this time out of pure curiosity :) I am pretty new to the disease and pretty new to this forum as some of you know... But already I have seen three people talking about IBS (including me). I know it is not much, but I haven't met anyone besides me with IBS before so seeing even two other people here is a big deal for me! So I was wondering if IBS was also common with PsA, even though they are essentially really different. One is a functioning problem with no physical cause and the other is an autoimmune disease. But then again, IBS is one of those conditions with "no explanation", so I thought I would give it a shot. Anyone else have Irritable Bowel Syndrome? Because if it is common with PsA, I think I had it coming for eight years!


I think there’s no relation, other than that a certain percentage of the general population will be diagnosed with it, so there will be overlap.

Inflammatory bowel is a different issue.


For years, my bowel issues were said to be irritable bowel. It was never investigated beyond mentioning it to the gastroenterologist who does my colonoscopy every five years. (My Dad had bowel cancer.) Before Enbrel, I had “issues” pretty much every day. Since Enbrel, rarely.
So I wonder whether “irritable” was, in fact, correct. Whatever, I’m good now!


My IBS that lasted a few years stopped a couple years ago. But, since I've been on Enbrel I've had some weird episodes that were quite severe. It seems to happen within a couple days after I've taken Enbrel, but I don't think Enbrel is the cause, it's just a coincidence. Thank God it's only happened four times in 6 months. My dad had celiac disease, and that is an autoimmune disease I think, but I don't think cramps are a symptom of that--just diarrhea.


I've been diagnosed with IBS, whatever that means. I always figured it had something to do with all of the medications, and fluctuations in symptoms have always been tied to antibiotic or other prescription use or cessation (like when I was on doxycycline for acne for several months I had a very upset stomach virtually the entire time, and now that I'm taking tramadol at bedtime I have the opposite problem.)


Back about 15 or 16 years I developed an abdominal pain that never went away. My then general practitioner spent quite alot of time palpating my abdomen and was able to locate the pain to the area around my ileocecal junction (join of small and large intestines). He tried giving me fibre supplements, anti-spasmodics but when nothing relieved it I got referred to a gastroenterologist, several examinations and a barium enema later there was an inconclusive conclusion so, as seems to be the default in these situations, it was given the 'irritable bowel syndrome' tag. As time has gone on my bowel seems alot more healthy ...... but then it took me a good while to realise that what had been normal for me my entire life (I was mid thirties at that point) ie. one bowel movements about every 5 days was actually not very normal or healthy at all!

Now it may or may not be connected with the PsA but all I can say is that I definitely had several "body blips" all around this time ..... the IBS, sun sensitivity and psoriasis all started up. Coincidence or connection, who knows?


I have IBS as well. Since I was in high school. Mine generally rotates around my hormone cycles, specifically mensuration. I have to stay on BCP to keep it regular. Also stress, spicy foods, etc.... trigger it. I have a colonoscopy every 10 years.


Hi again,

Well, it looks like IBS is pretty common. Maybe there's a connection, maybe it it just coincidence as Stoney said. But it was really interesting for me, since, like I said, I never met anyone else that had bowel issues like mine! So this is quite a high number for me personally meeting this many people in one forum with IBS :)

Mine was pretty severe. I had dropped two sizes in a couple of months (and since I was always quite skinny, those two sizes made me look like a skeleton!). I would wake up in the middle of the night and run to the toilet. I had abdominal pains that took my breath away. I had also stopped eating at one point (and that was AFTER I had dropped two sizes!) because I had somehow associated eating with discomfort. At one point Celiac was suspected, but I never had an endoscopy due to a number of reasons. I still wonder, but since I have not gotten worse and gotten better, even though it was never a hundred percent, it probably wasn't. But the interesting thing is, I realized when I have a flare, my bowel acts up a little to. But maybe that's due to inflammation and not IBS. This is a systemic disease after all.

So thank you guys for all your replies. Like I said, this question was out of pure curiosity. I'm not speculating anything :)


I also have IBS....didn't the book Psoriatic Arthritis The Facts talk about bowel issues being part of PSA? For anyone who has read it, I recall reading a section on this? I believe it was covered under secondary involvement?

A lady has borrowed my book and I have yet to get it back. I purchased the Oxford Rheumatology Library Psoriatic Arthritis book but this section was not in there.


To be honest I wouldn't be surprised as from what I have leaned so far...most auto immune disease starts in the gut. The gut being noted as the bodies second brain. I think maybe the researchers are looking at this more, hence the recent study on probiotics and RA. Just something to think about :-)


Maybe the inflammation also affects our intestines, but in a small amount so it is not seen in the bloodwork? Because when I had my first flare in May, there was no inflammation in the blood even though there was visible inflammation on my SI joint MRI so my diagnosis was inconclusive. The inflammation was only visible in the bloodwork on my second flare. I don't know. Or maybe our bowels are "irritated" by our systemic disease trying to find a place to break out? It was pretty much downhill for me after the diagnosis of IBS. At one point it was like my whole body was falling apart. There was something wrong with everything! And a few years ago I was obsessed with the idea that I had an autoimmune disease, but I thought along the lines of diabetes, or thyroid. I never for a second thought about inflammatory arthritis :)


Irritable Bowel Syndrome is a common problem to many people. In the overwhelming majority of cases it is just a disorder not a disease. It is mostly related to diet and stress. However there are many people who suffer from arthritis and IBS as well but it seems that anxiety and stress caused by arthritis affect bowel's functionality.

I know arthritis causes a lot of stress and it is difficult to handle this but you can change your diet and get relieved from IBS symptoms.

There are some foods which irritate the bowel. The best thing you can do is, keep a log where you will write which foods you consume every day and what symptoms they cause to you. With this way you will be able to find out the foods which deteriorate your problem.

The main suspects which cause symptoms are dairy products, beans, cabbage, cauliflower, broccoli, and raw fruits. However I can’t tell you what foods to avoid because IBS is an individualized problem. There is a lot of controversy about foods and the evidence are not so clear. For example many people tolerate well green salads while others not. You have to investigate in your problem and find which foods you can’t tolerate. It is a personal work and keeping a log could help a lot.

However there are some general guidelines you can follow.

Try eating small regular meals. You should have 4-5 small meals per day. Having large meals you overload your digestive system and deteriorate your IBS symptoms.

Drink more liquids. Water is the best. Drink at least 8 glasses of water daily. Avoid carbonated beverages, coffee and alcohol. Coffee and alcohol irritate the bowel and carbonated beverages cause more gas which make you feeling more bloated.

Exercise frequently. Exercise reduces stress and improves intestinal contractions.

Reduce gluten. Gluten has implicated a lot but fortunately more and more gluten free products come into the market every day.

Be careful with the dairy products. If you can’t tolerate lactose you can simply substitute milk with yogurt or drink milk without lactose instead.

Avoid fatty, fried and spicy foods. Pizza, sausages, bacon, and fried potatoes are not advisable.

Eat more fibres. Fruit and whole wheat products contain plenty of them. However there is a lot of controversy among IBS sufferers. Some sufferers feel better eating fruit and whole wheat bread while others say that their symptoms get worse after eating fibres. You can try to add a small amount of fibres in your daily diet and see how it goes. Or tell your doctor to recommend you a supplement.

Summarizing IBS isn’t a disease. It is a common disorder related to diet, stress and our lifestyle. Making some small changes we can improve it.


Vaggelis, first of all thank you for your reply. Don't get me wrong, I know IBS isn't a disease but I found it interesting that so many people have it here. Like I said the question was out of pure curiosity. And I think it makes sense that the stress caused by arthritis can make the bowel issues act up. That's probably why my bowel acts up a little everytime I have a flare.

About the diet though, I went on countless diets throughout the years hoping for a relief, but that didn't help much. Although I can't tolerate milk at all, and alcohol. Some fruits like oranges make my symptoms worse as well. So I stay clear of them :)

The only thing that truly helped was yoga. Only after I began doing yoga regularly my bowel movements became more regular and less distressing. I think it has both to do with the improvement of mental state and the exercise itself. And maybe my IBS is getting worse now because since I got diagnosed with PsA I haven't been able to move much.

Again, thank you very much for taking time and posting a detailed and beneficial reply!


Dafna Gladman and Vinod Chandran in their book "Psoriatic Arthrits - the facts" that TaraLynn mentions refers to PsA causing inflammation in other organs of the body including membranes such as in the eye (conjunctivitis/uveitis) and mucosal surfaces throughout the body including the mouth and bowel.

So I figure if you've had/got bowel issues it is possible for there to be a connection with PsA and possible that it is totally unrelated.


Jules, a couple of days ago in another conversation I was telling Seenie that I was somewhere in between connecting the dots and becoming paranoid and making up the dots because they seem to fit in :) And that's why I was asking too many questions: to know what the real dots are! Well, it seems like this time I probably I made up a huge dot, sorry :)


No need to apologize!
We all have dots. Not surprising, after what we have gone through,that we sometimes imagine dots from time to time. Some of our dots connect and some don’t. And then again, some don’t connect until there are other dots to connect them to. Take note of that dot. It may fit into one of your puzzles some day.

What’s important to remember is that you mustn’t let this disease make you dotty. :slight_smile:


Seenie you made me laugh :D

Too many dots to connect :) I guess my mind is a little fuzzy these days. I'm not flaring but I'm not feeling well either. I'm waiting for the day I will go to my hometown, and try and relax and maybe set some things in perspective. This has been too overwhelming.


No, no, no ladylazarus--you aren't making anything up! There are so many variables. Its like a calculus problem, I'm beginning to think--something which most of us couldn't begin to figure out or "connect the dots"!

I am the only kid of six in my family who has psoriasis or PsA. I'm the only one who's had IBS and other stomach problems, foot problems, neck and back problems (except my brother who recently had two vertebrae collapse--but that's osteoporosis), tendonitis, joint pain, swelling, nail deformities and fatigue-well, we KNOW for sure those are PsA, -- but we PsA patients all seem to have so many other symptoms, that you have to think (connect the dots) they are somehow related to PsA, if just a SE of PsA.

No, you're not imagining anything. It would be nice to wake up someday and realize it was just a bad dream--in some cases, a nightmare--wouldn't it?!


Well, I’m glad to have provided you with a laugh! I do believe that many of us have ignored more dots than we imagine. I know that is so in my case, anyway, and I suspect it is true for many of us here.
Do you know about Occam’s Razor? No, it’s nothing to do with chin hairs. It’s the problem solving principle which says that the simplest explanation is probably the most likely to be correct.
I’m sure you are looking forward to going home, connecting with your medics, and having home cooking! How long before you get to go?


Oh yes, lots of dots and some of them do connect but you only discover this way down the line.

Ladylazarus, have you got the book I mentioned? Seenie also recommends in the Book Reviews section. It's available as an e-book as well as a softback. It is an excellent read especially when everything about PsA seems such a mystery.

And you ask as many questions as you need anytime. It's the way we all support one another and also learn from the knowledge/experience sharing.