If you have PsA or psoriasis, you may be at greater risk for several other chronic conditions like gastrointestinal diseases.

Psoriatic arthritis (PsA) is a chronic inflammatory condition that affects the joints. It typically occurs in people who have skin psoriasis, but it’s possible to have PsA without skin involvement.

Research shows a possible genetic link between psoriatic disease and celiac disease and inflammatory bowel disease (IBD).

Some treatments for PsA like antitumor necrosis factor (anti-TNF) medications may lead to liver diseases like autoimmune hepatitis, but this is rare.

Treatments for PsA often overlap with treatments for bowel conditions like ulcerative colitis and Crohn’s disease.

Psoriatic arthritis doesn’t directly cause bowel problems. But there are some bowel conditions that you’re more likely to have if you also have PsA.

Specifically, there’s an association between PsA and IBD. IBD is a group of conditions that includes ulcerative colitis and Crohn’s disease.

While PsA is most closely linked to IBD, psoriasis is associated with a greater number of bowel conditions. If you have PsA and psoriasis, these might affect you.

Inflammatory bowel diseases (IBD)

Research shows that IBD and psoriatic disease have a close association. A data analysis published in 2020 of hospitalizations in the United States between 2000 and 2014 found that PsA and psoriasis were significantly associated with both Crohn’s disease and ulcerative colitis.

A 2022 genetic analysis may shed further light on the connection. It found that genetically predicted IBD led to higher risk of psoriatic disease, specifically psoriasis and PsA.

The 2022 analysis authors concluded IBD may cause psoriatic disease, but not the other way around. Crohn’s disease, in particular, may cause psoriasis or PsA, according to the authors.

Celiac disease

There’s not yet enough research to support a link between PsA and celiac disease, although some studies show celiac disease and psoriasis may be connected.

A 2022 study found genetic evidence that people with celiac disease are at a higher risk for psoriasis, but psoriasis was not a risk factor for celiac disease.

A 2019 review of studies found significant odds that those with Celiac disease also have psoriasis and that those who have psoriasis may also have Celiac disease.

A 2019 study found there’s no link between the amount of gluten in the diet and risk factors for PsA, psoriasis, or atopic dermatitis.

Autoimmune hepatitis

The 2020 hospitalization study found an association between psoriasis and PsA with liver diseases, such as autoimmune hepatitis (AIH). The same study noted that AIH is a complication of anti-TNF treatment for psoriatic disease.

A 2015 study found eight people in a center with 600 people got AIH after anti-TNF therapy with either the drug infliximab or adalimumab.

Nonalcoholic fatty liver disease

A 2017 cohort study found that people with psoriasis or PsA were more likely to have a new diagnosis of nonalcoholic fatty liver disease. This risk went up if people were taking systemic therapy, such as a disease-modifying antirheumatic drugs (DMARDs) like methotrexate.

Living with PsA can come with a number of complications besides bowel conditions such as:

A PsA treatment plan may help you manage the condition itself and minimize risk for these other conditions.

Some of the same drugs treat both bowel conditions and PsA. There are also additional treatments for each.

Overlapping treatments

Janus kinase (JAK) inhibitors

These small molecule therapies are a relatively new treatment. They reduce the activity of proteins involved with inflammation. They’re a promising treatment for a number of autoimmune conditions.

JAK inhibitors may be particularly effective for people with IBD who have ulcerative colitis. But JAK inhibitors may not work as well for Crohn’s disease. They’re an alternative to other therapies like biologics for people with PsA.


Biologic drugs target specific cells or proteins that are part of the immune system. Many of the same biologics are prescribed for IBD and PsA, such as infliximab and adalimumab. Some biologics are specific to IBD, such as vedolizumab, which prevents inflammation by stopping white blood cells from going into the gut.


Immunomodulators change how the immune system works. They may include some biologic agents. Other examples of immunomodulators are drugs like methotrexate, which may be prescribed for PsA or IBD.


Corticosteroids are anti-inflammatory medications. They’re used to treat flare-ups in both IBD and PsA, but in different forms. If you have swollen joints from PsA, your doctor may inject steroids into the joints to reduce inflammation and pain. For IBD, your doctor may prescribe topical or oral corticosteroids.

Other treatments for PsA

You can help manage PsA with other treatments including:

  • physical therapy
  • massage therapy
  • occupational therapy
  • splints and braces to support joints
  • exercise to maintain mobility
  • surgery to repair damaged joints

You may use a variety of PsA treatments to reduce symptoms and keep flare-ups under control.

Other treatments for gastrointestinal conditions caused by PsA

Treatments for gastrointestinal conditions depend on what condition you have.

First-line treatments for mild to moderate IBD include aminosalicylates, a class of anti-inflammatory drugs.

Some people with ulcerative colitis may have a colectomy, which is surgery to remove part of the bowel. People with Crohn’s disease with severe fistulas may also have surgery, such as an ostomy.

If you have psoriasis or PsA, the National Psoriasis Foundation recommends seeing a doctor regularly to screen for other conditions like IBD. Early detection may make treatment easier and more effective.

Psoriatic arthritis doesn’t directly cause bowel problems, but having PsA may put you at great risk for bowel diseases like ulcerative colitis or Crohn’s disease. Seeing a doctor for regular screening can help identify these other conditions early.