Ulcerative Colitis and Arthritis: What It Looks Like and How to Reduce Your Risk
Updated on May 8, 2026
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As if gut pain from ulcerative colitis (UC) weren't enough, about 10 percent of people with the condition will develop arthritis in their joints. In fact, arthritis is the most common complication of UC that occurs beyond the digestive system.
Although it's not fully understood, there seems to be a link between the gut and joints, says Harry D. Fischer, MD, a rheumatologist affiliated with National Jewish Health in Denver. For example, a bacterial infection in the digestive tract, such as salmonella or campylobacter, can cause a reactive type of arthritis, he says. In addition, both arthritis and UC have a genetic component.
Research backs Dr. Fischer up. In addition to the genetic theory, another possibility is that gut dysbiosis, or an out-of-balance microbiome (the collection of bacteria in the gut), changes immune function, leading to arthritis.
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5 Complications of Ulcerative Colitis
Ulcerative colitis is an autoimmune disease and a form of IBD. Complications from UC affect more than just the digestive track. Here are some things to watch out for.
What Arthritis Looks Like in Ulcerative Colitis
People with UC commonly have the following forms of arthritis, though other types can occur:
- Peripheral arthritis affects large joints of the arms and legs such as the knees, ankles, elbows, and wrists.
- Axial arthritis (aka spondylitis or spondyloarthropathy) causes pain and stiffness in the lower back and the joints that connect the pelvis and lower spine.
- Ankylosing spondylitis, a more severe type of arthritis that affects the spine, is an uncommon complication that affects 2 to 3 percent of people with IBD.
When IBD is treated and gut symptoms improve, arthritis symptoms typically improve as well.
Avoid These Pitfalls to Prevent Arthritis
Sometimes the steps you don’t take are just as important as the ones you do.
- Don’t ignore joint pain. Pain from UC and arthritis can feel similar, says Amar Naik, MD, a gastroenterologist at Midwest Digestive Health and Nutrition in the Chicago suburbs. This can look like joint pain, swelling, or reduced range of motion. Anytime you feel new or worsening symptoms, be sure to discuss them with your gastroenterologist.
- Avoid taking NSAIDs. Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen (Advil, Motrin), naproxen (Aleve), and aspirin can trigger or worsen UC symptoms, though some people can tolerate them. Ask your doctor if NSAIDs are safe for you to take. If not, you can try acetaminophen (Tylenol).
- Don’t smoke. Smoking can cause many health problems, but it’s also linked to inflammation throughout the body, which is one of the main triggers for arthritis.
- Limit fatty foods. Try to avoid saturated fat (found in foods derived from animals, like butter, cheese, and meat) and trans fats (found in certain processed foods), which research suggests may be linked to chronic inflammation.
- Don’t let your weight creep up. When you have arthritis, extra pounds add stress to weight-bearing joints like the knees, ankles, and hips, Fischer says. Stay as physically active as possible and eat a healthy, balanced diet.
Healthy Habits for Arthritis Prevention
Adhere to your UC treatment plan. Treating your UC can lower your chances of developing arthritis or ease arthritis symptoms if you already have joint problems. “If you can get your colitis under very good control and quiet it down, your arthritis will quiet down,” Fischer says.
Talk to your gastroenterologist about joint pain. You might think your gastroenterologist doesn’t need to hear about your achy joints, but they should be the first person you speak to about your symptoms, Dr. Naik says.
Tell your doctor which joints are affected, whether the pain is moving from one joint to another, and if there’s swelling. You should also specify whether your UC is in remission or if you’re in a flare, Naik says. Your gastroenterologist can help advise you on how to treat the symptoms. “If those things aren’t working, going to a rheumatologist can be very helpful,” he says.
Keep moving. Range-of-motion exercises are particularly important for people with arthritis, but any type of regular exercise can help you reduce arthritis symptoms. Yoga and tai chi, which can improve range of motion, may be helpful, Naik says. He recommends wearing proper footwear and avoiding high-impact exercises.
Work with a physical therapist. Because arthritis can limit your range of motion, a physical therapist can give you a plan to improve your flexibility and strength while reducing any pain. This is an important part of your treatment plan, Fischer says.
Maintain a healthy diet. Choosing anti-inflammatory foods may help ease arthritis pain. These include foods that are rich in omega-3 fatty acids like fatty fish (salmon and mackerel, for instance); olive oil; fiber- and protein-packed beans; antioxidant-rich fruits and vegetables; and green tea.
You may also want to cook with turmeric, Naik says. The spice contains a substance called curcumin, which may help reduce inflammation. A review of randomized, controlled trials that studied curcumin as a complementary therapy alongside medication in UC, found that it was effective at achieving clinical remission (eliminating symptoms) and clinical response (reducing symptoms) versus a placebo.
The World Health Organization recommends that a 150-lb person ingest less than 200 milligrams (mg) of turmeric per day; the limit for a 200-lb person is 270 mg per day. Be careful with supplements, which can come in high doses and aren’t regulated for safety or efficacy. They can cause adverse effects ranging from nausea to liver damage when consumed in excess.
Resources We Trust
- Cleveland Clinic: Managing Joint Pain When You’re Living With Ulcerative Colitis
- Mayo Clinic: Beyond the Gut: Extraintestinal Manifestations of Ulcerative Colitis
- Crohn’s & Colitis Foundation: Extraintestinal Complications of IBD
- Crohn’s and Colitis Canada: Joint Inflammation and Arthritis
- Harvard Health Publishing: Arthritis Associated With Inflammatory Bowel Disease
EDITORIAL SOURCES
Everyday Health follows strict sourcing guidelines to ensure the accuracy of its content, outlined in our editorial policy. We use only trustworthy sources, including peer-reviewed studies, board-certified medical experts, patients with lived experience, and information from top institutions.
Resources
- Joint Inflammation and Arthritis. Crohn’s and Colitis Canada.
- Extraintestinal Complications of IBD. Crohn’s & Colitis Foundation.
- Rath L. The Link Between HLA-B27 and Arthritis. Arthritis Foundation. June 24, 2022.
- Shafiee D et al. Enteric Infection-Associated Reactive Arthritis: A Systematic Review and Meta-Analysis. Journal of Clinical Medicine. June 12, 2024.
- Pan B et al. Investigating the Causal Impact of Gut Microbiota on Arthritis via Inflammatory Proteins Using Mendelian Randomization. Scientific Reports. November 10, 2024.
- Ulcerative Colitis. Harvard Health Publishing.
- Rath L. Smoking Can Be Hazardous to Your Joints. Arthritis Foundation. April 20, 2023.
- Antinoro L. Can Diet Improve Arthritis Symptoms? Harvard Health Publishing.
- Range-of-Motion Exercises for Arthritis. Harvard Health Publishing. February 23, 2026.
- Why Are Yoga and Tai Chi Beneficial for Our Bodies and Minds? Arthritis UK. May 20, 2022.
- 12 Best Foods for Arthritis. Arthritis Foundation.
- Supplement and Herb Guide for Arthritis Symptoms. Arthritis Foundation.
- Mohseni S et al. Curcumin for the Clinical Treatment of Inflammatory Bowel Diseases: A Systematic Review and Meta-Analysis of Placebo-Controlled Randomized Clinical Trials. Frontiers in Nutrition. March 23, 2025.
- Brenner-Fricke A. Turmeric and 10 Other Popular Supplements That Can Damage Your Liver. Yale New Haven Health. September 11, 2025.
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