Why can there be a time lapse between joint-pain onset of microscopic colitis and the onset of diarrhea?

It’s possible for a flare-up of microscopic colitis to consist of, initially, some joint aches (some patients may refer to it as “pain”), without the diarrhea, even though the gushing- or porridge-like diarrhea is a hallmark feature of this inflammatory bowel disease.

When a person with microscopic colitis has a flare, the joint pain and the diarrhea won’t always come at the exact same time.

The arthralgia may precede the diarrhea.

Why is this?

“Lag time may be caused by a combination of factors: diet, exercise, genetics, sleep patterns, stress, environment, ongoing medical conditions, viruses, infections, and your body’s individual inflammatory load,” explains Jeffrey Fine, MD, chief of gastroenterology at the Medical Surgical Clinic of Irving.

“The inflammatory load – how much inflammation the body is enduring and how much it can handle – varies from person to person.

We have built-in mechanisms that are supposed to help neutralize inflammation, but when your system becomes too overwhelmed, something has to give.”

To reduce inflammatory load, eliminate as many processed foods as possible. This means avoid eating foods from cans and boxes.

Eat as you would if there were no such thing as food factories or processing plants.

If you DO eat anything processed, opt for a minimally processed version, and make sure there are no unnatural ingredients. The more ingredients, the more processed.

The closer a food is to its natural form, the less pro-inflammatory it is: An apple is better than apple sauce is better than bottled apple juice is better than apple pie.

If you awaken one day with joint aches but no other new symptom, and you’ve already been diagnosed with microscopic colitis, and even if your last (and only flare-up) was several years ago—consider the possibility that this new-onset arthralgia is part of another flare-up of microscopic colitis and is simply lagging behind the characteristic diarrhea that will eventually be coming.

Dr. Fine has been in practice for over 25 years and specializes in digestive health, integrative medicine and food sensitivities.
Lorra Garrick has been covering medical, fitness and personal/cybersecurity topics for many years, having written thousands of articles for print magazines and websites, including as a ghostwriter. She’s also a former ACE-certified personal trainer.
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Top image: Shutterstock/  Emily frost