When I was in college, I developed stomach problems, which were identified as irritable bowel syndrome (also known as spastic colon, but not to be confused with inflammatory bowel disease (Ulcerative Colitis and Crohn’s Disease). If I ate a lot of roughage, Chinese food, or drank black coffee, within no more than a half an hour, I would find myself needing to find a bathroom right away. While it hindered my social life, it also may have been the start of my immune system problems.
I have heard a lot of discussion from people about the importance of the balance of intestinal flora for overall health, and this seems to be fairly well documented (Bischoff 2011; Isolauri, Kirjavainen, and Salminen 2002).
This also may be even more so in the case of RA.
According to one article, “THE rheumatologist must be constantly aware of his patient’s gastrointestinal tract for three reasons. First, the rheumatic diseases may affect the gut; secondly, the treatment of rheumatic diseases may have gastrointestinal effects; and thirdly; predominantly gastrointestinal diseases may have musculoskeletal components” (Haslock and Wright 1974: 51).*
Another article states that “Changes in the composition of bacterial populations might elicit an imbalance in proinflammatory and anti-inflammatory immune mechanisms…” (Scheinecker and Smolen 2011: 73).
One study found “[T]hat a primary abnormality in rheumatoid arthritis may be a reaction to a food antigen(s) and that the disease process starts within the intestine” (Podas, et al. 2007).
In fact, this is not a new idea. Some have posited that overgrowths of bacteria are a potential cause of RA (Henriksson, et al. 1993; O’Mahony and Ferguson 1991).
When I first got sick, there was some thought that I may have been suffering from a systemic yeast infection, as a rogue yeast infection was one of the many early signs that my immune system was having issues.
Now this is a condition that if often disputed, and is most typically found in patients with AIDS (Hyman 2013). However, systemic yeast infections are a problem that can lead to intestinal and joint problems, along with a litany of other symptoms. Most importantly, this condition is also associated with issues of gut health.
On the flipside to all of this, however, is that “Early life exposure to normal bacteria of the GI tract (gut microbes) protects against autoimmune disease” (Helmholtz Centre For Environmental Research 2013).
So good bacteria in the gut, in the correct amount, can be immune system promoting. But too much of a good thing seems to be implicated in a host of negative effects, including the potential for RA.
According to the Mayo Clinic (2012), “[I]dentifying new biomarkers in intestinal microbial populations and maintaining a balance in gut bacteria could help physicians stop rheumatoid arthritis before it starts.”