Many People With IBD May Have Undiagnosed SpA

3/11/2025

According to a study published in The American Journal of Gastroenterology, more than one-third of patients with inflammatory bowel disease (IBD) who had no prior diagnosis of spondyloarthritis (SpA) were found to screen positive for the condition. This suggests that many people with IBD may unknowingly have SpA, including axial SpA (which primarily affects the spine and pelvis, leading to lower back pain and stiffness) and peripheral SpA (which affects the arms and legs, causing joint pain and swelling).

There are two main types of IBD: Crohn’s disease, which can affect any part of the digestive tract from the mouth to the anus, and ulcerative colitis, which primarily affects the colon and rectum. For people with IBD, SpA is one of the most common health issues outside the digestive system. However, the factors that increase the risk of developing SpA in people with IBD are not well understood.

To learn more about those factors, researchers conducted a study across six U.S. medical centers. They gave two different screening questionnaires—DETAIL (DETection of Arthritis in Inflammatory boweL diseases) and IBIS-Q (IBD Identification of Spondyloarthritis Questionnaire)—to people with IBD who had never been diagnosed with SpA. The study also collected information about patients’ demographics, medical history, and treatments.

Out of the 588 patients who completed the screening, 35% tested positive for SpA symptoms using at least one of the screening tools. Certain factors were linked to a higher likelihood of testing positive, including older age, being assigned female at birth, a history of smoking, prior bowel surgery (which suggests more severe IBD), and the use of biologic medications. Notably, patients who had used three or more different biologics to treat their IBD had the highest risk of screening positive for SpA. The type of IBD (Crohn’s disease vs. ulcerative colitis) did not seem to impact the likelihood of having SpA symptoms.

The researchers assert that more research is needed to confirm these findings and improve screening for SpA in people with IBD. People living with IBD who experience joint pain, stiffness, or back pain should consider discussing SpA with their doctor.

References:

• American Journal of Gastroenterology – Prevalence and Risk Factors of Spondyloarthritis Symptoms in a US-Based Multicenter Cohort of Patients With Inflammatory Bowel Disease
• Spondylitis Association of America – IBS Prevalent in People with axSpA; IBS Also Linked to Anxiety and Physical Inactivity
• Spondylitis Association of America – People with IBD Face Greater Risk of Spondyloarthritis, Study Suggests