ABSTRACT
Bypass arthritis occurs in patients who have undergone intestinal bypass operations, including jejunocolic or jejunoileal. The arthritis may be acute or subacute, is usually intermittent, and can last occasionally for short periods, only to recur. The most commonly affected joints are the metacarpophalangeal, proximal interphalangeal, wrists, knees, and ankles. It commonly is associated with a dermatitis, which can be pustular. Circulating immune complexes composed of bacterial antigens have been found in both the circulation and the synovial fluid and are thought to be the cause of this disorder. Treatment consists of NSAIDs and antibiotics such as tetracycline, but reanastomosis may be necessary for complete resolution of symptoms.
