What is the role of gut inflammation in the pathophysiology of enteropathic arthritis?

• A. It damages the intestinal barrier, enabling bacterial antigens to reach joints
• B. It has no role
• C. It only affects the joints
• D. It is prevented by antibiotics

Answer: (A)

Gut inflammation contributes to enteropathic arthritis by disrupting the intestinal barrier. When the mucosa is inflamed, its permeability increases, allowing luminal bacterial antigens and other microbial components to cross into the circulation. These antigens reach the joints and stimulate immune responses, leading to synovitis and related inflammatory joint symptoms. This gut–joint connection explains why arthritis often accompanies inflammatory bowel disease and why controlling intestinal inflammation can improve joint symptoms. It also fits with the idea that the process is driven by systemic immune activation, not by a process confined only to the joints, and why antibiotics don’t reliably prevent the arthritis.