Is there a role of probiotics in orthopedics?

Pain in the joints is a normal part of the process. In addition, weariness, stiffness, and swelling may occur. Those typical indicators indicate arthritic inflammation.

However, studies have shown that persons who have inflammatory arthritis frequently experience digestive issues: According to the findings of a study that was presented in the Arthritis Research & Therapy1, persons who have rheumatoid arthritis have a risk that is seventy percent more than the risk that those who do not have RA have of getting gastrointestinal (GI) issues.

Your digestive system and inflammatory arthritis:

The digestive tract is divided into an upper and lower part. Upper GI begins at the mouth and continues through the stomach to the beginning of the gastrointestinal tract and ends at the beginning of the large intestine. Recent research indicates that both can be impacted by inflammatory arthritis. Mayo Clinic researchers observed that rheumatoid arthritis patients have a higher incidence of gastrointestinal (GI) complications, including perforations (holes), bleeding, colon inflammation, and infections. The incidences of nausea, bloating, difficulty swallowing, and pain in the abdomen region are also increased in those with inflammatory arthritis2.

Possibly related are the following factors3:

Inflammation: Arthritis is characterised by persistent inflammation of the joints, but this inflammation can spread to other organs and systems, including the digestive system. Many of the gastrointestinal problems arthritis patients experience have a direct correlation to the inflammatory state in which their bodies are currently caught. Approximately 10% of RA patients may develop rheumatoid vasculitis, an inflammatory disorder of the blood vessels that can damage the gastrointestinal tract.

Weak Immune System: Stress from living with a long-term illness and the immune system suppression caused by rheumatoid disease may also contribute. This could manifest as stomach pain, an ulcer, or digestive problems.

Existing Co-morbidity: Fibromyalgia is yet another possible contributing factor. It's not uncommon for inflammatory arthritis like RA to come hand in hand with this kind of chronic pain. If you suffer from fibromyalgia, there is a good chance that you also have irritable bowel syndrome (IBS) because the two conditions frequently occur together. Symptoms of both conditions include stomach cramps, bloating, gas, and intermittent bouts of diarrhoea and constipation. Both RA and celiac illness have commonalities. For those with this gastrointestinal condition, consuming gluten causes intestinal damage.

People with RA, ankylosing spondylitis, and psoriatic arthritis are at increased risk for developing inflammatory bowel disease (IBD). IBD refers to two illnesses, Crohn's disease and ulcerative colitis, both of which are characterised by chronic inflammatory disease of the digestive tract, resulting in GI symptoms. It is possible because both inflammatory arthritis and IBD share a same genetic and environmental origin.

Role of Probiotics4,5:

The billions of bacteria, viruses, fungus, and other small animals known as microbiota that make up the gut microbiome serve several important purposes, including the digestion of specific carbohydrates, the support of the immune system, and the elimination of harmful infections (disease-causing microbes). The gut microbiome can only perform at its best when it is healthy and diversified. Traditional treatments for RA and PsA may benefit from the addition of good bacteria, but much remains to be discovered.

It is believed that probiotics improve health by increasing the number of beneficial bacteria already present in the digestive tract (gut microbiota). Some types of Lactobacillus and Bifidobacterium, for example, may be found in probiotic supplements and foods, so these bacteria aren't unique to human bodies.

Recent years have seen a growing body of evidence connecting the microbiome with RA symptoms and prognosis. Furthermore, the researcher identified changed gut microbiota as well as microbial function in persons who were in the early stages of rheumatoid arthritis (RA).

Probiotics, the good bacteria found in yoghurt and other foods and in supplements, are recommended by some medical professionals. Probiotic supplementation was associated with some degree of improvement in persons with RA, according to a meta-analysis of existing research6, but the authors stressed the need for further high-quality studies in this area. The disease activity and intestinal permeability of persons with PsA were reduced in another investigation after they received probiotics. After they stopped using the pills, the improvements quickly faded7.

There may not be a direct cause-and-effect relationship between your gut flora and RA at this time, but it certainly doesn't hurt to give your body a boost with some healthy bacteria from the food you eat. Fermented foods including pickles, sauerkraut, kimchi, yoghurt with live cultures, and kefir are great sources of probiotics. Foods include not only probiotics but also numerous other essential nutrients including vitamins and minerals. The high fibre content of whole meals has been linked to increased feelings of fullness and decreased hunger.

Reference:

  1. Hao, X. et al. The gut microbiota in osteoarthritis: where do we stand and what can we do? Arthritis Research & Therapy 23, 42 (2021).
  2. Dumain, T. How Inflammatory Arthritis Affects Your Gut, and 3 Ways to Ease GI Symptoms. CreakyJoints Learn more (2019).
  3. Gilbert, J., PhD & Peer-Reviewed, J. F. Reduce the Risk of Arthritis by Improving the Microbiome | Arthritis-health. Learn more.
  4. Do Probiotics Help Arthritis Symptoms? Learn more.
  5. Probiotics for Inflammatory Arthritis: Pros and Cons. EverydayHealth.com Learn more (2021).
  6. Pan, H., Li, R., Li, T., Wang, J. & Liu, L. Whether Probiotic Supplementation Benefits Rheumatoid Arthritis Patients: A Systematic Review and Meta-Analysis. Engineering 3, 115–121 (2017).
  7. Haidmayer, A. et al. Effects of Probiotic Strains on Disease Activity and Enteric Permeability in Psoriatic Arthritis–A Pilot Open-Label Study. Nutrients 12, 2337 (2020).