Both enteropathic arthritis (EA) and ankylosing spondylitis (AS) are types of arthritis that primarily affect the spine, but they are distinct in their causes and associations.
Enteropathic arthritis is a type of arthritis associated with inflammatory bowel diseases (IBD), such as Crohn’s disease and ulcerative colitis. The primary link between the two conditions is thought to be an abnormal immune response triggered by the IBD, which leads to inflammation in the joints.
On the other hand, Ankylosing spondylitis is a type of inflammatory arthritis that specifically affects the spine and sacroiliac joints (the joints where the spine meets the pelvis). It can cause inflammation and pain in the spine, and in severe cases, can lead to the fusion of vertebrae. Although the exact cause of AS is not known, it’s believed to involve genetic factors, specifically the presence of a gene known as HLA-B27.
The primary difference between these conditions is their association: EA is linked to IBDs, while AS is not. However, it’s worth noting that some people with AS may also have bowel inflammation or symptoms of IBD, and vice versa, making differential diagnosis between these conditions sometimes challenging.
Both EA and AS can lead to similar symptoms, such as back pain, joint pain, and stiffness, but the treatment and management strategies may differ based on the underlying conditions and individual patient characteristics.
While the diseases are separate entities, there can be overlap, and some patients with IBD and EA may also have or develop features of AS. It’s also possible for a person to be diagnosed with both conditions. For this reason, any persistent back pain, particularly if associated with symptoms of IBD, should be evaluated by a healthcare professional for accurate diagnosis and appropriate treatment.
| Enteropathic Arthritis | Ankylosing Spondylitis | |
| Definition | A form of arthritis that’s associated with inflammatory bowel diseases, such as Crohn’s disease and ulcerative colitis. | A type of inflammatory arthritis that specifically affects the spine and sacroiliac joints. |
| Associated Conditions | Primarily associated with inflammatory bowel diseases. | Although not directly associated with IBD, a percentage of patients may experience IBD symptoms. AS is linked with the HLA-B27 gene. |
| Symptoms | Joint pain and inflammation, often in synchrony with IBD flare-ups. Can affect any joint but commonly affects the lower limbs and spine. | Chronic pain and inflammation in the spine and sacroiliac joints, leading to reduced flexibility and potential fusion of the vertebrae. |
| Treatment | Managed with a combination of medication (NSAIDs, DMARDs, biologic therapies), lifestyle changes, and possibly surgery, alongside treatment for IBD. | Managed with anti-inflammatory medication, physical therapy, and potentially biologic therapies or surgery in severe cases. |
Is enteropathic arthritis the same AS ankylosing spondylitis?
No, enteropathic arthritis and ankylosing spondylitis are not the same, although they share some similar characteristics and symptoms. Both conditions fall under the umbrella of spondyloarthropathies, which are a group of diseases that involve chronic inflammation of the spine and joints.
Article by Dr. Naveen Bhadauria
