Changes in the colonic and oral mucosa and their association with clinical manifestations and SIgA levels: A cross-sectional study in patients with spondyloarthritis with symptoms and/or antibodies associated with gastrointestinal disorders

Few studies have been carried out in patients with SpA in search of gastrointestinal symptoms in a targeted manner, our results documented more gastrointestinal symptoms in patients with active SpA and differences in their presentation according to the subtype of SpA. Patients with active SpA have a higher presence of antibodies associated with gastrointestinal disorders compared to healthy controls and although the oral mucosa can also present lesions that are associated with different systemic diseases including those diseases of the digestive system, its evaluation is not traditionally performed in clinical practice. These lesions may be of immunological, nutritional or deficiency origin and may present clinical manifestations that extend from the oral cavity to the rectum. Since patients with SpA do not usually present the typical clinical symptoms of inflammatory bowel disease, such as frequent and severe diarrhea or bloody stools, these gastrointestinal symptoms are not carefully evaluated, let alone oral manifestations. Most of these patients have been considered asymptomatic. Therefore, an active search for subclinical alterations in patients with SpA could be suggested by means of a directed questionnaire and taking of gastrointestinal antibodies. Therefore define who should be taken to a colonoscopy and histological procedure for confirmation, it is additionally important assess the status of the oral mucosa by direct examination which may impact disease activity status and its relationship to HLA-B27.