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Not only does rheumatoid arthritis (RA) cause inflammation of the joints leading to pain and stiffness, it can also cause stomach bloating and other gastrointestinal (GI) symptoms. One study found that compared with people who don’t have RA, individuals with RA have a 50 percent higher chance of having GI problems in their lower digestive tract and a 70 percent higher chance of developing an upper digestive tract problem.
As one myRAteam member wrote, “I’ve been dealing with a constant bloated feeling, stomach pains that come and go (especially when I eat), and I also flip-flop between having constipation or diarrhea.”
Since people with RA are at an increased risk of developing GI issues, it’s important to discuss stomach problems with your doctor, even if they seem minor. Treating digestive arthritis symptoms early is one of the best ways to prevent them from worsening and to protect your health and overall wellness.
Rheumatoid arthritis itself doesn’t directly damage the stomach, but it can contribute to digestive problems in several ways. Chronic inflammation from RA can affect multiple body systems, including the digestive system.
More often, stomach issues stem from the medications used to manage RA — such as nonsteroidal anti-inflammatory drugs (NSAIDs), corticosteroids, and certain disease-modifying antirheumatic drugs (DMARDs), which can cause digestive side effects. Other coexisting conditions, like inflammatory bowel disease or fibromyalgia, can also contribute.
Rheumatoid arthritis stomach bloating can be an uncomfortable and difficult symptom of RA. Many myRAteam members have shared their struggles. One myRAteam member wrote, “Heartburn, upset stomach, bloating, and puking have been one of the main things that might be a side effect of my RA.”
GI problems can be especially distressing when dealing with other RA symptoms. As another member shared, “I’ve been having terrible stomach problems. Burning, heartburn, upset stomach, bloating. Wish it would calm down, along with all the joint pain. Anyone else have this?”
Stomach bloating can also cause uncertainty for people living with RA. One member considered different potential causes of their stomach issues: “Bad weekend with stomach pain, bloating, and cramps. It was better this morning, but I know something is not right. Might be a hernia, might be diverticulitis.”
Stomach bloating in people with RA may be caused by a few different factors, including inflammation, imbalances in the gut microbiome, medication side effects, and commonly co-occurring conditions.
While chronic inflammation from RA primarily affects the joints, it can also impact the digestive tract. If inflammation targets the digestive system, GI issues such as stomach bloating can occur.
Recent research has shown that people with RA often have gut dysbiosis, an imbalance in the bacteria that live in their digestive system. This imbalance may contribute to gastrointestinal symptoms like bloating and other digestive problems. Some studies also suggest that gut dysbiosis may lead to different forms of arthritis in the first place. However, the connection between gut health and RA continues to be actively researched.
Bloating may be caused by medications used to treat RA. Nonsteroidal anti-inflammatory drugs (NSAIDs) and corticosteroids can cause digestive symptoms including bloating, stomach pain, diarrhea, and constipation. Taking NSAIDs or steroids over a long period of time is the most common cause of digestive symptoms in people with RA. Combining corticosteroids and NSAIDs can increase the risk of digestive side effects, so it’s important to talk to your doctor before using them together.
One member experienced symptoms while taking the corticosteroid prednisone. “Yes, I did experience bloating when I was on prednisone,” they said.
The disease-modifying antirheumatic drug (DMARD) methotrexate is another cause of stomach discomfort frequently cited by myRAteam members. This medication can result in several gastrointestinal ailments, including stomach bloating, vomiting, diarrhea, and nausea. As one member wrote, “I had those problems, but found out they were side effects of the methotrexate (for diarrhea) and prednisone (for bloating).”
Many patients cannot continue treatment due to digestive side effects.
Additionally, newer targeted DMARDs like Janus kinase (JAK) inhibitors may cause holes to develop in the stomach (stomach perforations). However, this is not a frequent side effect. More research is needed to fully understand this effect, but it’s important to talk about this risk with your healthcare provider.
One helpful myRAteam member pointed out that “the bloating and abdominal pain can actually be from your IBD.”
RA and inflammatory bowel diseases (IBDs), such as Crohn’s disease and ulcerative colitis, are close-knit issues that have been associated with each other. Other common symptoms of IBD include:
Researchers have found that fibromyalgia — a condition that causes chronic musculoskeletal pain, fatigue, sleep issues, and emotional distress — frequently occurs alongside inflammatory arthritis like RA. Moreover, fibromyalgia often occurs with the GI condition irritable bowel syndrome (IBS), which can cause bloating and other intestinal symptoms that are difficult to treat. Fibromyalgia is frequently associated with RA, but many people have a difficult time accepting the diagnosis.
If you've been diagnosed with RA and have experienced stomach bloating, report it to your rheumatologist. Together, you can find a solution. You might need to work toward a medication change, or your doctor may decide to prescribe additional medication to help with side effects from your current medication.
Experts and myRAteam members advise the following to help keep stomach bloating at bay.
Getting the most out of your RA medications while minimizing side effects like bloating can be a difficult balance. One member who experienced GI issues while taking methotrexate and prednisone shared, “Since I’ve gotten off of them, I’ve experienced none of that, but I have been suffering without the meds.”
Talk to your doctor about the best way of adjusting your medication to help alleviate bloating. Some myRAteam members have shared that they were able to split their medication up — taking half in the morning and half at night — to help resolve their issues. Others have switched from pills to injections to reduce gastrointestinal problems.
Another helpful option is to use gastrointestinal protectors or antiemetics (medications to help with nausea and vomiting) before taking your RA treatment. Never stop taking your medications or adjust your dosage without getting approval from your doctor.
Another possible solution to stomach bloating is over-the-counter medication. One myRAteam member shared that they take famotidine, an antacid, to help prevent GI issues. “I always take it before dinner or anytime I am going to be eating anything even slightly spicy. You can get it at Walmart in the pharmacy section.”
Another member recommended: “Take some Tums (antacids) a few times during the day and see if that helps.”
Proton pump inhibitors (PPIs) may be recommended for people taking NSAIDs to help prevent stomach problems. These medications reduce the amount of acid your stomach makes, which can help protect against ulcers and reduce bloating. However, long-term use of PPIs should be monitored by a doctor due to potential side effects like increased risk of bone fractures and certain infections.
As always, seek medical advice from your doctor before taking any new medications, even if they are found over the counter.
Some of this discomfort may come from the foods you eat. Certain foods and ingredients may cause bloating, including dairy, fructose (a naturally occurring sugar), and fried food. To help you identify whether your diet is contributing to your stomach bloating, you may want to try eliminating certain food groups and observing how your body responds.
One myRAteam member recommended eating bland for a week: “No caffeine, sodas, spicy foods, greasy foods, or alcohol.”
Another wrote that they “try to eat small amounts spread throughout the day” to avoid stomach bloating.
Increasing the amount of fiber in your diet can help with bloating. It’s best to gradually increase your fiber intake, so you don’t overwhelm your digestive system. When you first start to incorporate fiber into your diet, you may notice initial bloating and gas until your body gets used to it.
Some people find that probiotics, whether through supplements or fermented foods like yogurt and kefir, can help support gut health and reduce bloating. These dietary changes may help restore balance to the gut bacteria and improve digestion.
One myRAteam member shared, “I started taking a probiotic along with a greens powder for detox and cleanse in the morning … I have hardly had an issue since I started. Prior to that, I was bloating on a daily basis no matter what I ate.”
Keep in mind that dietary interventions are personalized and should be guided by a healthcare provider or dietitian who understands your specific needs and medical history.
On myRAteam, people share their experiences with rheumatoid arthritis, get advice, and find support from others who understand.
What has helped you manage stomach bloating or other digestive problems with RA? Let others know in the comments below.
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I have found when on autoimmune protocol diet, my joint pain and bloating goes away, but since that elimination diet is very bland, I live with an awareness that what I eat is directly related to… read more
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