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The key clinical manifestations of Rheumatic heart disease (RHD) include several distinct cardiac symptoms.Carditis, a hallmark of acute rheumatic fever, involves inflammation of the heart's endocardium, myocardium, and pericardium. Chronic RHD often results from recurrent episodes of carditis. Its symptoms include the following:Murmurs are caused by valvular damage, especially to the mitral and aortic valves. Mitral stenosis or regurgitation is common, with characteristic heart murmurs...
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Crohn’s disease is a chronic, relapsing form of inflammatory bowel disease characterized by segmental, transmural inflammation that can affect any part of the gastrointestinal tract. Its pathogenesis arises from a combination of genetic susceptibility, environmental exposures, epithelial barrier dysfunction, and immune dysregulation. Together, these factors lead to an exaggerated immune response against components of the gut microbiome.Genetic and Environmental InfluencesMultiple genetic...
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Association Between Rheumatoid Arthritis and Gastrointestinal Comorbidities: Evidence From Taiwan's National Health

Li-Hua Huang1,2, Yu-Hsun Wang3, Tzu-Jung Wu1,2

  • 1Department of Nursing, Chung Shan Medical University Hospital, Taichung, Taiwan.

International Journal of Rheumatic Diseases
|March 8, 2026
PubMed
Summary

Rheumatoid arthritis (RA) patients have higher risks for benign gastrointestinal (GI) issues like ulcers and GERD. However, RA is not linked to most GI cancers, with some even showing lower incidence.

Keywords:
GERDNHIRDepidemiologygastrointestinal cancergastrointestinal comorbiditiesgut–joint axisinflammatory bowel diseasepeptic ulcerrheumatoid arthritis

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Area of Science:

  • Gastroenterology
  • Rheumatology
  • Immunology

Background:

  • Rheumatoid arthritis (RA) is a systemic autoimmune disease with extra-articular manifestations.
  • The gastrointestinal (GI) tract is a potential site for RA involvement.
  • Limited large-scale data exist on RA's association with GI comorbidities, both cancerous and non-cancerous.

Purpose of the Study:

  • To investigate the association between rheumatoid arthritis (RA) and various gastrointestinal (GI) conditions.
  • To compare the prevalence of benign and malignant GI comorbidities in RA patients versus controls.

Main Methods:

  • Retrospective nested case-control study using Taiwan's National Health Insurance Research Database (2000-2019).
  • 75,670 RA patients were matched 1:4 to 302,680 controls without RA.
  • Conditional logistic regression analyzed the prevalence and adjusted odds ratios (aOR) for GI conditions.

Main Results:

  • RA patients showed significantly higher odds of benign GI conditions: peptic ulcer disease (aOR: 1.72), gastric ulcer (aOR: 1.52), GERD (aOR: 1.49), and inflammatory bowel diseases.
  • Associations between RA and benign GI conditions remained robust across age and sex strata.
  • Most GI cancers were not significantly associated with RA; stomach cancer (aOR: 0.66) and liver/bile duct cancer in females (aOR: 0.74) showed inverse associations.

Conclusions:

  • Rheumatoid arthritis is significantly linked to an increased prevalence of benign GI comorbidities.
  • RA is not associated with an increased risk for most GI malignancies.
  • Findings underscore the need for GI screening in RA management and support the gut-joint axis relevance in autoimmune disease.