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[INVOLVEMENT OF THE GASTROINTESTINAL TRACT IN RHEUMATIC DISEASES].

Aim
The aim of the present study was to show different aspects of the interrelation between pathology of the gastrointestinal tract and rheumatic diseases based on literature rewiev, single-centers data and case reports.


Materials and methods
First literature review was performed (databases PubMed, Medline). Then was analyzed information according presence of gastrointestinal disease in 126 patients with axial spondyloarthritis (SpA) and collected case reports as illustration the problem.


Results
Involvement of the gastrointestinal tract in rheumatic diseases in general is characterized by clinical, etiologycal and pathogenetic heterogeneity. It was found a few typical combinations: the defeat of the digestive tract as one of the clinical manifestations of rheumatic disease (hemorrhagic vasculitis, etc.); the defeat of the digestive tract and rheumatic disease as equal related conditions (Crohn’s disease and ankylosing spondylitis); the defeat of the digestive tract as a consequence of long-existing inflammation (amyloidosis, esophagus Barrett); gastrointestinal tract involvement as complication of treatment of the rheumatic disease (bleeding when using nonsteroidal anti-inflammatory drugs); rheumatic disease as a manifestation of paraneoplastic syndrome of the digestive tract. The presence of diseases of the gastrointestinal tract is established in more than half (58%) patients with axial SpA. In the group of patients considered the most frequently met gastritis (15%), chronic pancreatitis (15.9%) and chronic cholecystitis (19%).


Conclusions
Gastrointestinal tract occurs no less than half of the patients with rheumatic diseases and may be either primary or secondary to systemic disease. The possibility of coexistence of diseases of the gastrointestinal tract and rheumatic disease must be taken into account in the course of patient care. In some cases, treatment should be carried out together - a gastroenterologist and a rheumatologist.