DIEASES: RHEUMATOID ARTHRITIS
IMMUNE SYSTEM
The immune system works to keep germs and other foreign substances out of the body and destroy any that get in. It's made up of a complicated network of cells and organs. It protects the body from infection, cancer, and other conditions. Lymph nodes are part of the immune system. They send out lymphocytes. These are a certain type of white blood cell that fights infection. The blood vessels and lymph vessels carry the lymphocytes to and from different areas in the body. The B cells make specific antibodies to fight germs. The T cells kill the germs by killing the body cells that are affected.
When the immune system doesn't work correctly, it leaves you at risk for disease. The immune system also plays a role in rejecting transplanted organs or tissue. Other examples of immune disorders include:
Autoimmune diseases, which include type 1 diabetes, rheumatoid arthritis, multiple sclerosis, lupus, and certain types of anemia (this is when your immune system attacks its own body's tissues)
Immunodeficiency diseases, which include AIDS and severe combined immunodeficiency (SCID)
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DISCRIPTION OF RHEUMATOID ARTHRITIS
Rheumatoid arthritis is a chronic inflammatory disorder that can affect more than just your joints. In some people, the condition can damage a wide variety of body systems, including the skin, eyes, lungs, heart and blood vessels.
An autoimmune disorder, rheumatoid arthritis occurs when your immune system mistakenly attacks your own body's tissues.
Unlike the wear-and-tear damage of osteoarthritis, rheumatoid arthritis affects the lining of your joints, causing a painful swelling that can eventually result in bone erosion and joint deformity.
The inflammation associated with rheumatoid arthritis is what can damage other parts of the body as well. While new types of medications have improved treatment options dramatically, severe rheumatoid arthritis can still cause physical disabilities.
Symptoms
Tender, warm, swollen joints
Joint stiffness that is usually worse in the mornings and after inactivity
Fatigue, fever and loss of appetite
Factors that may increase your risk of rheumatoid arthritis include:
Your sex. Women are more likely than men to develop rheumatoid arthritis.
Age. Rheumatoid arthritis can occur at any age, but it most commonly begins in middle age.
Family history. If a member of your family has rheumatoid arthritis, you may have an increased risk of the disease.
Smoking. Cigarette smoking increases your risk of developing rheumatoid arthritis, particularly if you have a genetic predisposition for developing the disease. Smoking also appears to be associated with greater disease severity.
Excess weight. People who are overweight appear to be at a somewhat higher risk of developing rheumatoid arthritis
DIEASES RHEUMATOID ARTHRITIS
Rheumatoid arthritis usually starts to develop between the ages of 30 and 60. But anyone can develop the condition. The four stages of rheumatoid arthritis are:
Stage 1: In early-stage RA, there’s inflammation in the tissue around your joints. You may have some joint pain and stiffness. If your provider orders X-rays, they won’t see destructive changes in your bones.
Stage 2: The inflammation has begun to damage the cartilage in your joints. You might notice stiffness and a decreased range of motion.
Stage 3: The inflammation is so severe that it damages your bones. You’ll have more pain, stiffness and even less range of motion than in stage 2. You may start to see physical changes.
Stage 4: In this stage, the inflammation stops but your joints keep getting worse. You’ll have severe pain, swelling, stiffness and loss of mobility.
COMPLICATIONS DURING RHEUMATOID ARTHRITIS
Osteoporosis. Rheumatoid arthritis itself, along with some medications used for treating rheumatoid arthritis, can increase your risk of osteoporosis — a condition that weakens your bones and makes them more prone to fracture.
Rheumatoid nodules. These firm bumps of tissue most commonly form around pressure points, such as the elbows. However, these nodules can form anywhere in the body, including the heart and lungs.
Dry eyes and mouth. People who have rheumatoid arthritis are much more likely to develop Sjogren's syndrome, a disorder that decreases the amount of moisture in the eyes and mouth.
Infections. Rheumatoid arthritis itself and many of the medications used to combat it can impair the immune system, leading to increased infections. Protect yourself with vaccinations to prevent diseases such as influenza, pneumonia, shingles and COVID-19.
Abnormal body composition. The proportion of fat to lean mass is often higher in people who have rheumatoid arthritis, even in those who have a normal body mass index (BMI).
Carpal tunnel syndrome. If rheumatoid arthritis affects your wrists, the inflammation can compress the nerve that serves most of your hand and fingers.
Heart problems. Rheumatoid arthritis can increase your risk of hardened and blocked arteries, as well as inflammation of the sac that encloses your heart.
Lung disease. People with rheumatoid arthritis have an increased risk of inflammation and scarring of the lung tissues, which can lead to progressive shortness of breath.
Lymphoma. Rheumatoid arthritis increases the risk of lymphoma, a group of blood cancers that develop in the lymph system.
TREATMENT OF RHEUMATOID ARTHRITIS BY NUTRITIVE VALUE
Rheumatologists are experts in joint diseases. They work with a team of health professionals including specialist nurses, physiotherapists, occupational therapists, pharmacists, podiatrists and sometimes dietitians who give advice on medications, pain management, exercises to improve joint function and diet. Up to 75% of people living with RA believe diet plays a key part in their symptoms. Published data found 50% of people have tried to alter their diet.
Fatty fish. Salmon, tuna, sardines, herring and other cold-water fish are rich in omega -3 fatty acids, which may help control inflammation. Your body needs a healthy balance of omega-3 and omega-6 fatty acids. Researchers have found that a greater ratio of omega -6 s to omega-3 s is associated with an increase in chronic inflammatory diseases like R A. So it’s important to reduce omega- 6 s – which may provoke inflammation and are found in meats, certain oils and in fried and processed foods that contain those oils – and increase omega- 3 s.
Fruits and veggies. Fruits and vegetables are rich in antioxidants, which help stabilize molecules called free radicals that can trigger inflammation and damage cells. They’re also packed with vitamins and minerals the body needs and in polyphenols, all of which may help lower C-reactive protein (CRP), a marker of inflammation. To get the greatest health benefits, eat several types of fresh or frozen fruits each day, but watch out for sugar content in frozen options. Eat a colorful variety of veggies to get the most nutrients. Aim for two cups of fruits and two and a half to three cups of vegetables per day – fewer if you get less than 30 minutes of exercise a day and more if you’re more active.
Whole grains. Oats, whole wheat, brown rice, quinoa and other whole grains may lower levels of CRP and reduce the risk of heart disease, which is elevated in people with RA. Whole grains are higher in nutrients and fiber than refined grains. Plus, many products with refined grains contain ingredients that are not healthful, such as added sugars and saturated fats. Read labels and choose breads, cereals and other products that specify a whole grain as a primary ingredient.
Peas and beans. These legumes are a great source of protein, which is important for muscle health – and people with RA are prone to muscle loss. What’s more, peas and beans are practically fat free, contain antioxidants, and some are rich in folic acid, magnesium, iron, zinc and potassium, all known for their heart and immune-system benefits. Black, garbanzo and red kidney beans and black-eyed peas are good choices.
Nuts. Full of healthful monounsaturated fat, nuts are recognized for their heart-protective properties and important nutrients. Try pine nuts, pistachios, hazelnuts and almonds. Walnuts are particularly good for people with R A because they’re high in omega-3 fatty acids. (Ground flaxseed is another good plant source of omega -3s.) But don’t go overboard eating nuts; they contain healthy fats, but they are also high in calories.
Olive oil. Use olive oil instead of other oils and fats. In addition to healthy mono unsaturated fat, it contains a compound called oleocanthal that reduces inflammation and acts like ibuprofen in alleviating pain. But eat it in moderation; as with all oils, it’s a fat that can lead to weight gain.
IRON RICH FOODS: Anaemia is a deficiency of red blood cells to transport oxygen around the body. Anaemia can be caused by chronic inflammation, medications and impaired iron absorption. Therefore adequate dietary intake of iron such as spinach, eggs, seeds, beef, dates, fruits is important to help prevent fatigue. Tiredness is a very common symptom of RA and can be made worse by anaemia.
CALCIUM RICH FOODS : It is important that everyone gets enough calcium in their diet to ensure that their bones stay strong and healthy. This is an even greater consideration when you have R A and are using glucocorticoids as part of the treatment. It may put you at a higher risk of developing osteoporosis as well as weight gain. Good source of calcium include low fat milk, yoghurt and cheese, green leafy vegetables, soya drinks with added calcium, almonds and fish where you eat the bones, such as sardines and pilchards.
REFERENCE
Research indicates that omega-3 fatty acid supplementation may offer benefits for individuals with rheumatoid arthritis (R A). A meta-analysis published in 2012 reviewed 10 randomized controlled trials involving 370 R A patients and found that daily intake of at least 2.7 grams of omega-3 polyunsaturated fatty acids for a minimum of three months significantly reduced nonsteroidal anti-inflammatory drug ( NSAID) consumption. While there were trends toward improvements in tender joint count, swollen joint count, morning stiffness, and physical functions.
However, maintaining adequate levels of these nutrients is essential for overall health, particularly because R A patients may be at increased risk for osteoporosis and anemia. Therefore, it's important for individuals with R A to monitor and manage their iron and calcium levels as part of their comprehensive healthcare plan.
Article by
Abeer Anwer
To professor
Dr Nauman khan