Treatment of the Gastro-Intestinal Tract in Chronic Rheumatoid Arthritis*
Rheumatoid arthritis still remains one of the great therapeutic problems of the age. Etiologic factors are still indefinite, although infection and the allergic reaction to infection seem the most logical explanation at the present time, but these do not seem to explain satisfactorily all the peculiarities and complexities of this disabling disease. Until the time when the cause and treatment of this moot problem is generally understood and agreed upon by the students and investigators of rheumatoid arthritis, research must continue its endeavor to unravel the mystery. The present study was undertaken to determine what, if any, evidence could be found in the digestive tract of these patients which might be of value in the solution of this therapeutic problem.
Evidence has been accumulating for some time that points to a possible role of the gastro-intestinal tract in arthritis. Constipation and colon dysfunction are such frequent accompanying symptoms that Lane1 went so far as to advise colectomy to remove the intestinal stasis which he considered the cause of arthritis. Unfortunately, this work was marred by over-enthusiasm. Rare indeed is the arthritic patient who has not gone through a siege of drastic and unphysiologic purging and not infrequently at the doctor’s suggestion.
The gastro-intestinal tract has also received much attention through the possible role that diet might play in arthritis. Protein, carbohydrates, various combinations of fool and most recently the vitamins have been duly incriminated. Granted that most of this has been pure theory, and all too frequently the theory of. . .