Functional Gastrointestinal Disease In Patients with Rheumatoid Arthritis: Disease Activity, Functionality, and Quality of Life

Abstract Rheumatoid arthritis (RA) is an autoimmune disease characterised by systemic inflammation, with gastrointestinal symptoms being among the most common extra-articular manifestations. Functional gastrointestinal disorders (FGIDs), which occur in the absence of an organic cause, are reported more frequently in patients with autoimmune diseases. This study investigated the rate of FGIDs in RA patients, its relationship with RA disease activity, and its effect on the quality of life of RA patients. All RA patients completed the Rome IV questionnaire, the Short Form 12 (SF-12), and the Health Assessment Questionnaire (HAQ) to assess disease and general health. The Disease Activity Score (DAS 28), the number of tender and swollen joints, and acute-phase reactant levels were used to assess disease activity, with results recorded together with demographic data. Of the 115 RA patients, 54.8% had FGIDs, with the most common type being functional dyspepsia (FD) (39.1%). Other diagnoses included irritable bowel syndrome (16.5%), functional constipation (13.9%), and functional diarrhoea (7.8%). Patients with FGIDs had higher DAS28 scores compared to those without (median 3.77 [interquartile range: 2.68] vs. 2.96 [1.99]; p=0.017). After applying the Bonferroni correction for multiple tests (corrected significance level p