Reiter's syndrome has many possible symptoms, with arthritis (joint
inflammation) being an important one. There is no cure for Reiter's syndrome,
but you can control the symptoms.
Signs and Symptoms
|Arthritis—includes pain, swelling, stiffness, and redness of joints.
Usually occurs on one side of the body and usually involves joints of the
spine, pelvis, legs, fingers, toes, wrists, feet, or ankles. |
|Conjuctivitis (inflammation under eyelids)—usually brief and mild |
|Iritis (inflammation of the iris)—affects 5 percent of people with
Reiter's and needs immediate medical treatment to avoid eye damage |
|Urinary tract infection—burning during urination may or may not occur; may
have pus drainage from penis |
|Painless, shallow ulcers on the penis |
|Pus-filled sores on soles, palms, and penis; mouth sores |
|Weight loss, malaise, morning stiffness, fever |
|Heart problems (rarely) |
What Causes It?
Reiter's is a reactive arthritis, which means that another illness triggers
it. Scientists do not know what actually causes Reiter's. But they know that the
following factors often precede Reiter's.
|HLA-B27 gene—20 percent of people who have this gene get Reiter's; about
80 percent of people with Reiter's have the HLA-B27 gene. |
|Bacterial triggers, such as salmonella, shigella, campylobacter |
|Sexually transmitted disease triggers, such as chlamydia |
|White males ages 20 to 40 are at higher risk. |
What to Expect at Your Provider's Office
Tell your health care provider about any intestinal conditions or sexually
transmitted diseases you have had recently. You may have a blood test to exclude
other diseases and to see if you have the HLA-B27 gene.
Treatment focuses on managing the various symptoms. Specialists for each
symptom usually are needed. Your health care provider will give you drugs to
reduce inflammation and pain and to maintain movement. Physical therapy can
improve muscle tone, maintain your range of movement, and alleviate walking
disturbances. Occupational therapy can teach you how to perform tasks with less
stress on your joints. Surgery to reconstruct joints is performed if necessary.
Psychological counseling or self-help groups for support and coping skills can
be very helpful.
|Nonsteroidal anti-inflammatory drugs (NSAIDS)—for example, indomethacin,
reduce inflammation; side effects include gastrointestinal irritation,
bleeding, and ulceration |
|Corticosteroids—decrease inflammation and control pain |
|Sulfasalazine—experimental drug for arthritis; usually well-tolerated but
possible problems with long-term use |
|Methotrexate—taken orally or by injection for chronic arthritis; used
experimentally for Reiter's syndrome; frequent blood and liver tests are
Over the Counter
|Nonsteroidal anti-inflammatory drugs (NSAIDS)—for example, ibuprofen |
Complementary and Alternative Therapies
Alternative therapies may be effective with fewer side effects than drugs.
|Glucosamine sulfate (500 mg three times a day): stimulates cartilage
growth and may be as effective for pain relief as NSAIDs without the side
|Avoid nightshade family (tomatoes, potatoes, eggplant, peppers, tobacco);
decrease saturated fats and alcohol (which can cause inflammation); increase
oily fish, nuts, and flaxseed (which can decrease inflammation); increase
fruits and vegetables (bioflavonoids). |
|Vitamin C (1,000 to 3,000 mg a day), vitamin E (400 to 800 IU a day),
beta-carotene (25,000 IU per day), selenium (200 mcg a day) |
|Essential fatty acids (2 tbsps. oil a day or 1,000 to 1,500 mg twice a
day): mix of omega-6 (evening primrose) and omega-3 (flaxseed) |
|Minerals: zinc (45 mg a day), copper (1 mg a day), bromelain (500 mg three
times a day) to reduce inflammation |
Herbs may be used as dried extracts (capsules, powders, teas), glycerites (glycerine
extracts), or tinctures (alcohol extracts). Unless otherwise indicated, teas
should be made with 1 tsp. herb per cup of hot water. Steep covered 5 to 10
minutes for leaf or flowers, and 10 to 20 minutes for roots. Drink 2 to 4 cups
Turmeric (Curcuma longa), 400 mg three times a day: helps with morning
stiffness and joint instability, works well when taken with bromelain
For urethritis: Mix three to four of these herbs in equal amounts and use 1
tsp. of mixture. Drink 1 cup tea three times a day or 30 drops tincture three
times a day. Take daily during an acute flare-up and two weeks of the month as a
|Juniper (Juniperus communis): a diuretic, for inflammatory
conditions of the urinary tract; avoid if you have kidney disease. |
|Uva ursi (Arctostaphylos uva-ursi): used as an antibacterial and
anti-inflammatory for lower urinary tract; for acute cases of Reiter's only
|Horsetail (Equisetum arvense): soothing diuretic |
|Licorice (Glycyrrhiza glabra): soothing, anti-inflammatory, do not
take if you have high blood pressure. |
|Meadowsweet (Filipendula ulmaria): anti-inflammatory |
|Horsetail, licorice, meadowsweet (see dosage directions above) |
|Eyebright (Euphrasia officinalis) and bilberry (Vaccinium
myrtillus) have been historically used for inflammation of the eyes. Drink
30 to 60 drops tincture three times a day, or 1 cup tea three times per day,
or use tea to make compresses for acute relief: soak a cotton ball or cloth in
a cooled tea and place over the eyes. |
As with other forms of arthritis, acupuncture may be effective at stimulating
the immune system and reducing inflammation.
The initial attack usually lasts three to six months. Most people maintain
near-normal lifestyles with physical and occupational adjustments.
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