How rheumatoid arthritis damages the entire body

If you’re familiar with rheumatoid arthritis (RA), it's no secret that it affects your joints, making pain a regular part of everyday life. But the autoimmune disease doesn't stop there. Many people with RA have additional problems with their heart, lungs, eyes, skin, and more, thanks largely to inflammation. Sometimes, the issues aren't caused by RA itself, but by the drugs used to treat the condition. 

Here are some of the most common complications reported by people with RA, and what you can do to help lower your risk.

Besides joint pain, people with RA are most likely to have lung issues, which show up eight times more often than they do in adults without RA. Interstitial lung disease (ILD) is the primary cause, affecting about 10 percent of the RA population. People who smoke, those diagnosed after age 60, and men are particularly vulnerable, even though women are two to three times more likely to have RA.

Caused by scarring and inflammation, ILD is difficult to catch early, tough to treat, and can affect your breathing to such a point that you may need a lung transplant. To help prevent its development, health professionals recommend kicking cigarettes for good and treating the underlying RA.

With RA comes chronic inflammation. And with chronic inflammation often comes heart disease. 

The 1.3 million Americans with RA have a greater risk of heart attack and stroke than people without RA. They are also more likely to have increased hardening of the blood vessels and more pericarditis, or irritation of the sac surrounding the heart. That's not all: Studies find people with RA have a much higher chance of developing blood clots, as well, including especially dangerous clots that travel to other parts of the body.

To help address potential heart complications, experts advocate a healthy diet, regular exercise and, of course, treatment. Biologic therapy has been shown to be particularly effective.

In addition to your heart and lungs, RA can disrupt your digestive system. Having constipation or diarrhea is fairly typical, and some with RA report bleeding, perforation (small holes), ulcers, and blockage. Colon inflammation, called colitis, is often another familiar problem. 

It's not just the disease acting here, though. Medication plays a big role in RA-related GI issues. The corticosteroids and nonsteroidal anti-inflammatory drugs (NSAIDs) used for treatment can cause stomach irritation and even bleeding ulcers. To address the pain, healthcare providers might scale your medications back and will recommend not smoking.

People with conditions like lupus or RA often have another autoimmune disease called Sjögren's syndrome, also linked to inflammation. It can make eyes and mouths feel dry. There is no cure, but it can be treated with eye drops and medication. 

Another RA-related eye issue: scleritis, which causes redness, irritation, and vision problems and could lead to blindness if left untreated. It occurs when the sclera, the white part of your eye, becomes inflamed, and can be addressed using corticosteroids, NSAIDs, or stronger immunosuppressives.

People with RA are also more vulnerable to skin problems, and serious issues can indicate more acute RA. Slower-healing wounds and nodules are common. Nodules are nubs of tissue that can appear in your lungs or under your skin, frequently near joints. They're unsightly but not usually painful.

A potentially more painful skin issue: shingles, an itchy, burning rash, caused by the varicella-zoster (chickenpox) virus, that’s typically found splashed across someone's face or torso. There's a two- to three times higher chance of developing shingles if you have RA, mostly because corticosteroids used to treat the disease weaken your immune system enough for the shingles virus to flare up. Antiviral drugs can help.

Rheumatoid arthritis also affects:

• Bones: Osteoporosis is a often big concern of people with RA because it primarily impacts women and is one more obstacle to movement. 
• Nerves: Inflammation associated with RA can pinch or damage nerves, causing problems like carpal tunnel syndrome. 
• Immunity: In addition to RA itself, the drugs used to treat the disease can weaken resistance to illness.

Good nutrition, regular exercise, more screening, physical therapy, medication and quitting smoking can help ease these conditions, and the impact of RA overall. Remember to report any unusual symptoms to your healthcare provider, either way.