For patients
Enteropathic (IBD-associated) arthritis
enteropathic arthritis, IBD arthritis, Crohn's arthritis, ulcerative colitis arthritis
Are you a clinician? See the clinical version of this page.
The short versionThis is arthritis linked to inflammatory bowel disease (Crohn's or ulcerative colitis). The most important thing for a healthy pregnancy is keeping the bowel disease well controlled, so your care is shared between rheumatology and gastroenterology. Many of the medicines overlap and can be continued in pregnancy.
- Keeping the bowel disease calm is the single most helpful thing for a good pregnancy.
What to know
The priority: control the bowel disease
A calm, well-controlled bowel disease before and during pregnancy gives the best outcomes. Active IBD raises pregnancy risks more than the arthritis does.
Shared care with gastroenterology
Your rheumatology and bowel teams work together, since many decisions and medicines are shared.
Medicines
Sulfasalazine, azathioprine, and TNF inhibitors can usually be continued. Some bowel-disease biologics are also continued in pregnancy. Methotrexate is stopped before trying.
How the arthritis behaves
Peripheral joint symptoms often rise and fall with the bowel disease, while spine and pelvis symptoms follow their own pattern.
After birth
Both bowel and joint disease can flare after birth. Your teams plan restarting medicines, including options that suit breastfeeding.
iThis page helps you prepare a conversation with your care team. It does not replace individual medical advice. Always confirm your own plan with your rheumatology and pregnancy team.
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When to call your team
- A bowel flare: worsening diarrhoea, blood in the stool, or severe abdominal pain.
- A significant joint flare, or general pregnancy red flags.
- Before changing any medicine, since bowel and joint treatments are linked.