Rheumatoid arthritis (RA) is the most common autoimmune disease affecting about 1 percent of the population.
Although tremendous improvements in treating RA have been made, the origins of the illness remain a mystery. However, there is an accumulating body of research suggesting that the root cause of RA may be found in the quality of the bacteria in the bowels and how we react to them.
RA is an autoimmune illness resulting in inflammation and destruction of the joints, most commonly the hands and wrists. The average age of onset is 50 years and women are affected three times more often than men. Unfortunately, the incidence of RA appears to be on the rise.
RA is a serious illness. Five years after diagnosis, 30 percent of patients are unable to work. After another five years, 50 percent are seriously disabled. RA (and the medications used) also increase the risk of cardiovascular disease, osteoporosis, infections and bone marrow cancers. Life expectancy is reduced by an average of 56 years.
There is a correlation between specific bacterial infections and an increased risk of RA. Bowel bacteria such as Proteus mirabilis, Escherichia coli, Mycoplasma, Klebsiella pneumonia and Porphyromonas gingivalis all have a strong link to inflammatory arthritis. Porphyromonas gingivalis causes periodontitis and may induce the production of RA-specific autoantibodies, anti-CCP antibodies.
The bacteria in our bodies constantly interacts with the immune system and most of the immune system is in the bowels. “Bad” bacteria cause an increase in inflammation and that imbalance and inflammation in the bowel can increase the risk of autoimmune disease.
The bowels are very complex and play a primary role in our health.
Most look at the bowels as a place where food is digested and absorbed and where waste material is excreted. Medical research has discovered that the bowel is the primary organ regulating what actually enters the body.
This complex barrier controls the equilibrium between tolerance and immunity to non-self antigens. It is also well-known that a “leaky” intestinal barrier (aka leaky gut) increases the risk of autoimmune illness.
There is no doubt that genetics have an important role in developing RA and we have no control over them. However, environmental factors probably play a bigger role and we can exert substantial control over them.
Factors that increase the risk of bowel leakiness include diet, stress, many medications — particularly antibiotics — and especially in childhood, smoking and sleep.
I do not believe that autoimmune diseases need to be permanent. I am a fan of newer RA medications because they do prevent joint damage, but with lifestyle changes they may not be needed forever.
The immune system is a dynamic organ that is constantly responding to the environment. I have seen success with specific supplements, probiotics, diet and therapies that focus on changing the environment and ultimately the immune response itself.
There is enough medical research to indicate that these nontraditional medical therapies are beneficial in the treatment of RA and we should use them.
• Dr. Patrick B. Massey, MD, PH.D., is medical director for complementary and alternative medicine at Alexian Brothers Hospital Network and president of ALT-MED Medical and Physical Therapy, 1544 Nerge Road, Elk Grove Village. His website is www.alt-med.org.
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