WHAT IS rheumatoid arthritis?
Rheumatoid arthritis (RA) is a disease of unknown cause, which occurs in genetically susceptible individuals with the effect of various environmental factors, and can affect many organs and structures in the body, especially the joints. One of the most severe inflammatory rheumatism known
WHO CAN GET rheumatoid arthritis?
RA can occur anywhere in the world and in all races. It is seen 2-3 times more frequently in women than in men, but it is reported that this rate becomes equal in advanced ages. It can be seen at any age after the age of 16, but it is most common between the ages of 30-50.
WHAT IS THE FREQUENCY OF rheumatoid arthritis?
Its incidence in different populations varies between 0.5% and 1%. It has been reported that the annual probability of new cases ranges from about 3 per 10000 people. Considering that it is seen in 5 out of 1000 adults with a similar frequency in our country, and if we assume that there are 40 million adults at the moment: There are at least 200,000 RA cases in our country and 12000 new cases are included in this number every year.
DO GENETIC FACTORS PLAY A ROLE IN THE FORMATION OF rheumatoid arthritis?
It is accepted that there is a genetic effect in RA. RA is four times more common than expected in first-degree relatives of seropositive patients. There is a risk of 12-15% in identical twins and 2-5% in fraternal twins. Genetic factors are thought to depend on the genes of the HLA system located on chromosome 6, and several genes rather than a single genetic disorder are thought to affect RA.
WHAT ARE THE SYMPTOMS OF rheumatoid arthritis?
In the typical case, pain and swelling in the wrists, elbows, stiffness and pain in the middle part of the fingers called PIP, MCP, and in the joints of the hand bones and fingers, in the fingers of the hand, in the form of difficulty in using their hands, develop when they wake up in the morning.
It can potentially affect all joints. However, the above-mentioned joints and foot joints, ankles, knees, jaw joint called temporomadibular joint and less commonly the neck joint are involved.
DO YOU HAVE SYMPTOMS OTHER THAN THE JOINT?
Of course, it can involve many organs and structures other than the joint. Before joint symptoms appear, nonspecific findings such as fatigue and weight loss may be seen.
The most common EYE symptoms occur outside of the joint. Keratoconjunctivitis sicca (DRY EYE) is the most common ocular finding in RA. Apart from this, especially scleritis and episcleritis are seen.
Nodules under the skin most commonly occur around the elbow fingers. It is painless and is usually detected in severe cases.
Water collection by involvement in the lung membrane; Involvement in the lung itself can lead to increasing shortness of breath over time.
Involvement of the kidneys is not common. However, it is important that the kidneys are healthy. Because in order to use some drugs used in the treatment of the disease, the kidneys, liver and even lungs must be intact.
IS THERE ANY CONSEQUENCES IN THE PREGNANCY OF THE FEMALE PATIENT WITH rheumatoid arthritis?
RA itself does not affect a person’s fertility. Some drugs used in its treatment, such as Methotrexate, affect fertility. There is no harm in getting pregnant for a RA patient, provided that she consults her doctor and stops some of her medications. On the other hand, patients with RA during pregnancy show up to 75% improvement and remission; After pregnancy, the disease exacerbates in 80-90% of the cases.
DOES SMOKING HAVE ANY EFFECT ON THE OCCUPATION OF rheumatoid arthritis?
The relationship between smoking and rheumatoid arthritis is essentially the 15th century. is based on. Before the discovery of America, rheumatoid arthritis was not a well-known disease in Europe, but after these years, rheumatoid arthritis has become more common. One of the reasons for this may be that tobacco came to Europe from America. It is estimated that one out of every three cases of rheumatoid arthritis is caused by smoking.
If the person has a genetic predisposition to this disease, smoking almost invites the disease. This risk is even greater in smokers with a family history of rheumatoid arthritis. The formation of ACPA protein* (Anti-citrullinated proteinantibodies) is increased in smokers who carry the HLADRB1 gene.
Smokers who have smoked a pack of cigarettes a day for 20 years have been shown to have too much ACPA in their blood. In those who quit smoking, it was seen that the risk decreased depending on how long ago they quit smoking. For example, ACPA was found in the blood of people who quit smoking 20 years ago, equal to those who never smoked. In other words, those who quit smoking 20 years ago and those who have never smoked in their lives carry the same risk.
Men constitute a higher risk group than women.
The situation is worse in those with a genetic predisposition. Smoking can trigger the development of the disease in people with a genetic predisposition.
DOES DENTAL PROBLEMS HAVE A ROLE IN THE OCCURATION OF RATH?
William Osler “A healthy mouth is the window to a healthy body.” He said.
Periodontitis (PD) is one of the most common intraoral infections that cause tooth loss in adults. It is a chronic and slowly progressing infection and causes inflammation of the gums, bleeding, loss of adjacent bone and tooth decay over time. Even in developed societies, oral hygiene has been found to be impaired by more than 80%.
Among patients with chronic PD, RA has been reported to be 3.95%, which is higher than 0.5-1% in the general population. In the same study, this frequency was found to be 0.66% in patients who applied for non-PD dental disease. On the other hand, advanced periodontal disease was detected in 65% of these RA cases.
HOW IS rheumatoid arthritis treated?
It is recommended to lose excess weight, exercise regularly, pay attention to our diet, and avoid stress within general health rules. If you can’t quit smoking or have gum problems, treatment should be done. Close cooperation with the physician must be established. How and in which doses the drugs will be used and what to pay attention to should be learned from the physician. In the slightest doubt, you should consult your doctor.
A wide variety of drugs are used in the treatment of the disease. Non-Steroidal Anti-Inflammatory Drugs (NSAIDs), corticosteroids (cortisone), methotrexate, hydroxychloroquine, sulphsalazine, leflunomide and biological agents (such as TNF alpha brokers, Anti CD20 drugs) that have become widespread in recent years are the main drugs used. Since the initiation and follow-up of these require special knowledge and experience, continuous follow-up of our patients is required. Periodic examination and blood tests are required.
HOW CAN I PROTECT FROM rheumatoid arthritis
Quitting Tobacco Products: Cigarettes and other tobacco products have been held responsible for the formation of rheumatoid arthritis. Especially those with a family history of rheumatoid arthritis should not smoke. Smoking can also lead to a more severe disease picture in ankylosing spondylitis cases. Although it has been claimed that smoking is protective for osteoarthritis, there is now more evidence to the contrary. As a result, smoking can lead not only to the formation of cancer or bronchitis, but also to the formation of rheumatism.
Gingival Inflammations: Since gingivitis may be responsible for the formation of rheumatoid arthritis, dental problems should be treated as soon as possible.
Exercise: Regular exercise is essential for joint health as well as general health. Sports such as brisk walking and swimming are very important for bone, joint and muscle health.
Nutrition: It is necessary to have a healthy and balanced diet by acting within the general health rules. Eating fish (such as salmon, mackerel, tuna, sardines, bluefish, cod, herring) frequently provides you with vitamin A and omega 3 substances, which both reduce triglycerides and can suppress rheumatoid arthritis. In general, enough vegetables, fruits and grains. It is necessary to consume. Getting enough sun and a calcium-rich diet are essential for bone health. Consuming more than 5-6 cups of coffee a day and drinking more than one glass of soda a day can damage bone metabolism.
As a result, adults with pain in the joint fingers and morning stiffness should definitely be investigated for RA. This disease is a chronic disease that can be seen in every society and at any age after the age of 16, can cause destruction in the joints, and can involve the lungs, eyes, and less commonly the heart, as well as the joints. Genetic factors are important in the formation of this disease, but some environmental factors such as smoking and priodontitis facilitate the emergence of the disease in people with genetic predisposition. For this reason, it is necessary for people with RA in their family to quit smoking and solve their dental problems urgently.
