9 Tips for Managing Gastrointestinal Side Effects from RA

Patient Expert
View as:|
1 of 10

Many RA meds have one side effect in common: they can make your gastrointestinal system very unhappy. Acid reflux or GERD can make it feel as if there's a roiling vat of acid burning up your mid-region. Then there's nausea, bloating, gas and constipation or diarrhea that can feel very similar to Irritable Bowel Syndrome (IBS). Speak to your doctor about your symptoms. If they seem to be side effects of your medications most of the time, it's possible to find a way to manage them.  Here are some tips for soothing your stomach.

Acidophilus or probiotic

Probiotics are a type of live microorganisms that can help balance the natural bacteria in your gut, which may also balance the functioning of your bowels, addressing both constipation and diarrhea.The only "side effect" can be loose stools if you're taking too much. If that happens, reduce the dose. Talk to your doctor before taking them.


Ginger can be a wonderful aid to help control nausea. Buy fresh ginger in the grocery store and slice or grate it on dishes, such as stirfry, for flavoring. Put a piece the size of a nickel in hot water for a soothing drink. Add a squeeze of lemon or a bit of honey depending on your preference. You can also buy ginger root supplements. Talk to your doctor before taking.

Hot drinks and teas

Caffeinated beverages, such as coffee and tea, can be hard on an upset stomach. Instead, try herbal varieties, such as peppermint, and (again) ginger teas. Years ago, my shiatsu therapist told me about hot water with a small slice of lemon - oddly enough, it can work miracles on acidic stomachs.

Make sure you eat

Eating is the last thing you want to do when you stomach is upset, but it can help keep the acid down to a dull roar. If your stomach is empty, you're going to feel the symptoms of acid even more. Avoid foods that can trigger acid reflux and stick to mild, bland foods, such as steamed chicken and fish, rice, bread and crackers.

Eat specific foods

If your medication makes you constipated, including high-fiber foods in your diet can help regulate you. Eat lots of fruits and vegetables, choose high grain breads instead of white, learn to love high-fiber cereals. If you get diarrhea, stay away from high-fiber foods until it's resolved. Certain foods such as nuts, beef, blueberries and white rice can make you constipated.

Over-the-counter medication

Dramamine is an excellent antinausea medication, but can make you drowsy so don't take it if you have to operate heavy machinery or drive your car. Certain over-the-counter medications can block the production of stomach acid. They include Prilosec OTC and Zantac. Talk to your doctor about what the best choice is for you. For occasional relief of acid reflux, heartburn and indigestion, use antacids such as Gaviscon, Maalox and TUMS.

Prescription medication

Over-the-counter medications that block the production of stomach acid are for milder cases. If you have more severe symptoms that cannot be managed with over-the-counter medication or the other tips in this article, talk to your doctor about prescription drugs. PPIs such as Nexium, prescription Prilosec and Pantoloc can be very useful to manage these types of symptoms.

Stress management

Stress releases hormone and immune system proteins that impacts not just on your emotional health, but your physical health, too. Many physical symptoms can be triggered by stress, including stomach upset and diarrhea. Finding a way to manage - or reduce - stress may help. Simple breathing exercises as well as yoga and meditation may help reduce overall stress. Talk to your rheumatologist to know how to protect your joints.

Know your limits

A big part of managing side effects is knowing when enough is enough. Your medication is supposed to help you live a better life. If side effects end up significantly affecting your quality of life, it may be time to talk to your doctor about treatment options.