Does Rheumatoid Arthritis Begin in the Intestine?

It's not widely known, but the results of numerousintestine (allowing potentially harmful bacterial antigens
clinical trials over the last 30 years have pointed to aninto the blood stream) seems to be the key issue.
intriguing connection between rheumatoid arthritis andDarlington notes that 'RA patients untreated by
the intestines. As long ago as the 1940s, Charles denonsteroidal anti-inflammatory drugs (NSAIDs) have
Coti-Marsh in his pioneering research into the causesnormal gastrointestinal permeability, but patients on
and treatment of arthritis declared 'the disease beginsNSAIDs and perhaps also on disease modifying
in the bowel.' Nowadays there is increasing evidenceantirheumatic drugs show increased permeability. Such
that he was right.increased permeability may allow food or bacterial
Unfortunately, the connection between arthritis and dietantigens to be absorbed in greater quantities than
has historically been downplayed, with nutrition neverusual, overwhelming normal gut defences and, possibly
quite making the grade as an object of scientific study.producing symptoms of RA.'
More recently, however, the development of nutritionalWhat that means is that dietary manipulation could, in
biochemistry. immunology and pharmacology, as welltheory, reduce gastrointestinal permeability, with
as ever increasing scientific data on free-radicalreduced absorption bacterial antigens - and perhaps
disease, antioxidants, prostaglandins, and flavonoidstreat one of the causes of rheumatoid arthritis. Despite
have lifted the subject of nutrition out of the realm ofthese findings, and others like them, making dietary
anecdotal uncertainty into the province of crediblechanges in order to treat arthritis is considered to be
science.'alternative', in other words unacceptable to the
In Joints and Arthritic Disease (2002), Dr Gail Darlingtonmajority of the orthodox medical community.
references a number of research projects, forDoes rheumatoid arthritis begin in the intestine? Quite
example a study by O'Farrelly which took smallpossibly - there is some evidence to support the
intestinal biopsies from 93 patients with rheumatictheory. However, 'alternative' theories rarely attract
arthritis (RA) and compared them to those of a controlcommercial interests, which is of course the prime
group. The conclusion was that the gut may play asource of research funding. It therefore remains to be
part in the immunopathogenesis of certain cases ofseen whether complementary and alternative
RA.therapies will ever achieve the status of 'proven' as
The combination of the development of certain typesrequired by Western science.
of gut flora and an increased permeability of the