How Does Psoriatic Arthritis Affect Your Gut?

PsA and IBD are often roomies — so if you have psoriasis and/or PsA (about 15% of people with psoriasis also have PsA), it’s possible you live with gut issues too.

It kinda makes sense that IBD and PsA go together. Both are autoimmune diseases. The same kind of glitch causes your immune system to attack your joints and skin in PsA and your gut in IBD.

A 2022 study found that people with IBD had a higher risk for psoriasis and PsA. Crohn’s disease had a much stronger link to PsA than ulcerative colitis did.

Genes are another thing both conditions have in common. Psoriasis and IBD share a few genes that are involved in (no surprise) inflammation.

People with PsA and IBD also have problems with their microbiome. “Micro” means “small” — like, really small. The microbiome is a teeny-tiny city in your gut (and other parts of your body) that’s home to about 100 trillion bacteria and other organisms.

Most are friendly bacteria that actually help you out by doing things like digesting food and creating vitamins. But a few are the bad kind that can make you sick.

Problems may develop when the balance of bad and good bacteria is off, which happens in PsA and IBD. Research has found that the microbiome changes in PsA and IBD look very similar.

PsA and IBD do have things in common, such as inflammation and genes, but they’re definitely not the same.

PsA is an inflammatory type of arthritis. It mainly affects people with psoriasis, although you don’t need to have psoriasis to get PsA.

The psoriasis part of PsA happens when your immune system revs up skin cell production. It’s like a skin assembly line moving at warp speed. The extra cells land on top of your skin, where they form scaly red and white patches called plaques. The “A” is for arthritis, which is the part that makes your joints swollen, sore, and stiff.

IBD includes two conditions: Crohn’s disease and ulcerative colitis.

Crohn’s can affect any part of your digestive tract, which runs all the way from your mouth to your butt. Ulcerative colitis affects only the lining of your colon — the bottom part of your GI tract.

How do you know if you have one or both of these autoimmune diseases? Here’s a quick guide to their symptoms.

PsA symptoms include:

• swollen, stiff, painful joints
• stiffness when you wake up
• extreme tiredness
• swollen fingers and toes that look like little sausages
• nail changes
• white, red, or silvery patches on light skin or pink, purple, brown, or gray patches on dark skin

IBD symptoms include:

• diarrhea
• stomach cramps or pain
• bloody poop
• unexpected weight loss
• extreme tiredness

There’s no magic pill to stop you from getting PsA or IBD. And you can’t change your genes (sorry!). But there are some things you can do to reduce attacks of symptoms, called flares:

• Keep taking your meds: Whether you’re on biologics or corticosteroids, stick to the plan. These meds tame the inflammation that causes your symptoms.
• Ditch the cigs: Smoking leads to more PsA and Crohn’s disease flares, and it could make your meds less effective at treating your disease. Consider seeking support to help you quit. Quitting can be hard, but your body will thank you.
• Revise your lifestyle: Stress, a lack of sleep, and a less-than-healthy diet are all possible flare triggers. Try keeping a diary of your symptoms to learn what sets them off. Then you can work with your doctor to make lifestyle tweaks. You may want to try practicing meditation or going to bed earlier.
• Get to know your doc: They can give you tips on how to avoid symptoms in your skin, joints, and gut.

With both IBD and PsA, remission is the goal. You want to get symptom-free ASAP and stay there.

Since you have more than one condition, you may need to see more than one specialist — a dermatologist and a rheumatologist for PsA and a gastroenterologist for IBD.

When it comes to meds, some of them do double duty by treating both conditions:

• Corticosteroids: These are not muscle-building steroids. Corticosteroids cool down your immune system to reduce inflammation. You take them for a short time to get a flare under control.
• Immunomodulators: These drugs basically turn down your immune system. Some work for both IBD and PsA.
• Biologics: These drugs are targeted, meaning they zoom in on the overactive parts of your immune system. A group of biologics called tumor necrosis factor (TNF) inhibitors can help with IBD and PsA.
• JAK inhibitors: These drugs block the pathways in your body that create inflammation.

If you have IBD, you’ll want to avoid some PsA meds, such as nonsteroidal anti-inflammatory drugs. These drugs might make your joints feel better, but they can worsen GI symptoms.

PsA on its own is a lot. Add IBD and you have even more symptoms to deal with and medications to manage.

Both PsA and IBD come and go in flares. If both conditions flare at the same time, you could be dealing with skin, joint, and gut symptoms all at once.

While neither disease has a cure, the outlook for both PsA and IBD has gotten a whole lot better. New medications are coming out all the time. So even if you have both of these autoimmune diseases, you’ve got good symptom-management options to choose from.

PsA and IBD have a lot in common, including inflammation and a few shared genes. If you have PsA, you’re more likely to have IBD.

But treatments are available, and some of the same meds can treat both conditions. You can work with a team of joint, skin, and GI specialists to find the treatment that best manages your symptoms.