Reactive Arthritis

As always, if I know someone who reaches out to me to ask if I have heard of other women who have been diagnosed with something I have not heard of, I first research to find out what it is and then I write a blog so that other women know about it. This is one of those times.

When the woman asked me about this I was surprised I had never heard of it, but I was even more surprised when I looked it up and knew women may want to know about this. You should also know she had all the mesh removed at UCLA some time ago, so this is really hard for her. This is what I found out when I looked it up.

Fast Facts

  • Reactive arthritis can affect the heels, toes, fingers, low back, and joints, especially of the knees or ankles.
  • Though it often goes away on its own, reactive arthritis can be prolonged and severe enough to require seeing a specialist. Effective treatment is available for reactive arthritis.
  • Reactive arthritis tends to occur most often in men between ages 20 and 50.
  • Most cases of reactive arthritis appear as a short episode. Occasionally, it becomes chronic.
  • Reactive arthritis is a painful form of inflammatory arthritis (joint disease due to inflammation). It occurs in reaction to an infection by certain bacteria. Most often, these bacteria are in the genitals (Chlamydia trachomatis) or the bowel (Campylobacter, Salmonella, Shigella and Yersinia). Chlamydia most often transmits by sex. It often has no symptoms, but can cause a pus-like or watery discharge from the genitals. The bowel bacteria can cause diarrhea. If you develop arthritis within one month of diarrhea or a genital infection – especially with a discharge – see a health care provider. You may have reactive arthritis.
  • In the past, it went by the name “Reiter’s syndrome.” Now it belongs to the family of arthritis called ‘spondyloarthrisis’She told me it is extremely painful and the drug she takes has pretty bad side effects. You will see many times in articles that a sexual disease may cause this, but you should be aware that because of everything you have dealing with mesh, it too could be responsible, so look past this fact and keep reading and do your own research.

What causes reactive arthritis?

The bacteria induce (cause) arthritis by distorting your body’s defense against infections, as well as your genetic environment. How exactly each of these factors plays a role in the disease likely varies from patient to patient. This is a focus of research.

Reactive arthritis can have any or all of these features:

  • Pain and swelling of certain joints, often the knees and/or ankles
  • Swelling and pain at the heels
  • Extensive swelling of the toes or fingers
  • Persistent low back pain, which tends to be worse at night or in the morning

Some patients with this type of arthritis also have eye redness and irritation. Still other signs and symptoms include burning with urination and a rash on the palms or the soles of the feet.

The reason I am sharing this is because if you are going through symptoms no one seems to understand and you don’t get any better, you may want to go to an infectious disease doctor for a proper diagnosis, which is what she did.

Who gets reactive arthritis?

The bacteria that cause reactive arthritis are very common. In theory, anyone who becomes infected with these germs might develop reactive arthritis. Yet very few people with bacterial diarrhea actually go on to have serious reactive arthritis. What remains unclear is the role of Chlamydia infection that has no symptoms. It is possible that some cases of arthritis of unknown cause are due to Chlamydia.

Reactive arthritis tends to occur most often in men between ages 20 and 50. Some patients with reactive arthritis carry a gene called HLA-B27. Patients who test positive for HLA-B27 often have a more sudden and severe onset of symptoms. They also are more likely to have chronic (long-lasting) symptoms. Yet, patients who are HLA-B27 negative (do not have the gene) can still get reactive arthritis after exposure to an organism that causes it.

Patients with weakened immune systems due to AIDS and HIV can also develop reactive arthritis. Many women after mesh implants or over time have weakened immune systems.

There is more to this than just what you are reading now, so hang in and I will share what I learned.

How is reactive arthritis diagnosed?

Rheumatologists are experts in diagnosing arthritis and other rheumatic diseases. Other doctors may feel less comfortable diagnosing reactive arthritis. This is because diagnosis is based on clinical features and not on tests.

Diagnosis is largely based on symptoms of the inducing infections and appearance of typical musculoskeletal (joint and muscle) involvement. If indicated, doctors might order a test for Chlamydia infection or test for the HLA-B27 gene. The test for Chlamydia uses a urine sample or a swab of the genitals.

How is reactive arthritis treated?

The type of treatment for reactive arthritis depends on the stage of reactive arthritis.

The early stage of reactive arthritis is considered acute (early). Acute inflammation can be treated with nonsteroidal anti-inflammatory drugs (often referred to as Nsaids. These drugs suppress swelling and pain. They include naproxen (Aleve), diclofenac (Voltaren), indomethacin (Indocin) or celecoxib (Celebrex). The exact effective dose varies from patient to patient. The risk of side effects of these drugs, such as gastrointestinal (often called GI) bleeding, also varies. Your doctor will consider your risk of GI bleeding in suggesting an NSAID.

The late stage of reactive arthritis is considered chronic. Chronic reactive arthritis may require treatment with a disease-modifying antirheumatic drug (sometimes called a DMARD) such as sulfasalazine or methothrexate. Sulfasalazine may be more useful when the reactive arthritis is triggered by a gastrointestinal (GI) infection. In some cases, very inflamed joints may benefit from corticosteroid injections (cortisone shots).

Talk to your physician about what to expect from treatment with NSAIDs and DMARDs. New research suggests that a prolonged course of two or more antibiotics might be effective in patients with chronic Chlamydia-induced reactive arthritis. However, more studies are needed.

I went to several sites to learn about this illness and learned it is very complicated and often happens with food poisoning. Read this.

How does reactive arthritis occur?

It is not clear why reactive symptoms develop in areas of the body that are not infected. When you have an infection your immune system makes antibodies and other chemicals to get rid of the infecting germ (bacteria, virus, etc). The battle between the immune system and infecting germs can create other chemicals and debris such as fragments of dead germs.

One theory is that some of this debris may get into the bloodstream. It may then lodge in certain areas of the body such as the synovium of joints. This may trigger the inflammation in the joint.

Infections that can trigger reactive arthritis include:

  • Infection of the urethra. Because many women have erosion in the urethra, this could be a trigger. By the time I made it to removal surgery, mine was eroding through my urethra. This is also called urethritis. It is the most common trigger. About 1 in 100 people who have an infection of the urethra also develop reactive arthritis. The urethra is the tube that passes urine out from the bladder. Some sexually transmitted infections can cause urethritis. Infection with a sexually transmitted bacterium is the most common. Symptoms of the infection include a discharge from the urethra and pain when you pass urine.
  • Infection of the gut. I know many women have problems when the mesh erodes through the colon. This is called gastroenteritis and is another common trigger. Various bacteria can infect the gut and cause vomiting and/or diarrhoea. For example, shigella, salmonella, campylobacter and yersinia. These infections are often caused by food poisoning. About 1 in 100 people who have a gut infection with one of these bacteria also develop reactive arthritis.
  • Infection with Chlamydophila pneumoniae. This bacterium can cause a respiratory tract infection (causing a cough or a lung infection) and can sometimes be a trigger.
  • Viral infections that can cause a sore throat, cough, or skin rash are sometimes the trigger. The infection may be mild and soon forgotten, but it may still trigger an arthritis.
  • No triggering infection can be found in about 1 in 10 cases.

What is the outlook (prognosis)?

At the onset of the disease, it is not possible to predict how long it will last.

  • In some cases, the symptoms last just a few weeks.
  • In most cases the symptoms last 3-6 months and then go completely without leaving any long-term problem. After the swelling and inflammation (arthritis) has gone, it is quite common to have niggly pains which continue for several further months.
  • In about 1 in 6 cases the arthritis lasts longer than twelve months. It can sometimes last for years. If joint inflammation continues for six months or more, you are at risk of joint damage which may cause long-term pain and disability. It is in these cases where disease-modifying medication may be used.

In some people who make a complete recovery, the symptoms return months, or even years, after the first episode. This may be a reaction to a new infection, or symptoms may just flare up for no apparent reason. So, if you have had one episode of reactive arthritis, you should take particular care to protect against sexually transmitted diseases and food poisoning which may trigger a further episode.

Note: the triggering infection is not within the joint itself. An infection within a joint is different and is called septic arthritis.

What the woman did tell me was that over time she had taken a lot of Levaquin which is a fluoroquinolone like Cipro. Immediately my skin pricked because of all I have read about these drugs and have written three blogs about them. I found a board where people are talking and if you cannot get diagnosed successfully, then you may want to go on there and read and ask questions. They are also discussing many of the side effects of drugs.

Sadly, drugs can cause so many awful and debilitating long term side effects which is why I refused to take many when offered. I did suggest to her that to treat it she may want to try taking the strongest grapefruit seed extract capsules to get rid of the infection and it is possible for women to be diagnosed with many diseases, when the mesh is the underline culprit. You can learn so much by reading and trying things to help yourself. This is an excellent site and I suggest every woman reads it.

This will take you to a blog I wrote about grapefruit seed extract and it has helped me get through so many issues with infections and it will lead you to all the blogs about Cipro and Levaquin.

This site shows photos of some of the side effects of this disease and I put one at the top of this blog because it is a shock to see rashes like this. You can learn a lot more on this site. And it explains in-depth many of the symptoms. Yes, there are many.


  1. Pam Beauchamp

    Maybe I am fortunate in the fact I am allergic to Cipro, all quinolone, and macrobid. If you call that lucky since most of those treat Uti’s. Arg.

  2. Sugar Sue

    LINDA..Just read this…what do u think about antidepressants, Liraca and Gabapentin?

    1. Linda (Post author)

      I would read all side effects, not just the most common ones BEFORE I take any prescription drug.


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