Rheumatologist Questions Rheumatoid Arthritis

Can RA cause problems with swallowing?

I have RA, i’m on methotrexate, sulfasalazine & about to start on humira. My hands & right wrist are affected, also my left shoulder & my neck & more recently my feet. I've been having problems with swallowing food, i can swallow ok when i’m not eating, it’s only when i’m trying to swallow food it can be difficult and painful. Could this be linked to my RA?

Female | 52 years old
Complaint duration: 10/04/00
Medications: Methotrexate, Sulfasalazine
Conditions: Rheumatoid Arthritis

6 Answers

If you are having trouble swallowing there are two things to consider:
1. The RA may have been triggered by Lyme disease which is associated with
neurological problems such as difficulty swallowing. If you are living in
an area where you would be exposed to Lyme, or have been in areas where you
could have been bitten by a tick, it would be worthwhile to pursue that.
People who carry the DR2 gene can develop RA after exposure to Lyme.
2. You may have a neurological component of your auto-immune disease. This
needs to be evaluated by a Gastroenterologist with a swallowing study, and
possible esophageal manometry because it can lead to choking and aspiration
of food into the lungs.
Good luck!
Painful swallowing also called odynophagia can be caused by several condition including but not limited to infection, ulcers, esophagitis, Barrett esophagus, recommend proper evaluation by gastrointestinal doctor to find the cause.
RA in itself does not cause swallowing problems. Due to your use of immune suppression medications, you are at risk for having infections, and one particular infection I will be concerned with is a fungal infection in the food pipe (esophagus). Please check with your primary care and if needed a gastroenterologist who could help you in that case. I would also recommend you let your rheumatologist know to look for other causes of swallowing problems.
Yes
It can be linked to having an extremely dry mouth. This process, called secondary Sjogrens, is very common in RA patients.

Thanks!

Best regards
There are many causes of your symptoms, so to further determine what is causing, you will need further evaluation. Historically, the most common sites of rheumatoid arthritis (RA) are the metatarsophalangeal joints, followed by the metacarpophalangeal joints and the cervical spine. Given your symptoms, these are very concerning and you should seek medical attention as soon as possible (your PMD or Rheumatologist). Abnormalities of the rheumatoid cervical spine generally can be grouped into 3 categories that may be seen in isolation or combined involvement, of which atlantoaxial instability (AAI) or atlantoaxial subluxation (AAS) is the most common abnormality. Please see the following link for more information: https://emedicine.medscape.com/article/1266195-overview