Behçet’s disease is common in the Middle East, Asia and Japan, and rare in Canada, the United States and Europe. In Middle Eastern and Asian countries, the disease affects more men than women. Elsewhere it affects more woman than men. Behçet’s disease tends to develop in people in their 20's or 30's, but can occur at any age.

• The cause of Behçet's disease is unknown.
• There have been reports of a virus found in some individuals with the disease.

Treatment for Behçet's disease is based on treating the symptoms to reduce discomfort and to prevent serious complications. Medication may be used to reduce inflammation and to regulate the immune system. Immunosuppressive therapy is also sometimes recommended.

As Behçet’s disease affects different parts of the body, patients usually need to visit several different doctors for treatment. It may be helpful to have one doctor coordinate treatments and monitor any side effects from the various medications. Often this doctor will be a rheumatologist, who is a specialist in treating inflammatory disorders like arthritis. 

The following specialists may also be required to treat other symptoms affecting different body systems:

• Gynecologist (treats genital sores in women)
• Urologist (treats genital sores in men)
• Dermatologist (treats genital sores in men and women, and skin and mucous membrane  problems)
• Ophthalmologist (treats eye inflammation)
• Gastroenterologist (treats digestive tract problems)
• Hematologist (treats disorders of the blood)
• Neurologist (treats central nervous system problems)

Medicine

Your doctors may prescribe creams or ointments to be applied directly onto the sores caused by Behçet’s disease, to relieve pain and discomfort. This medicine usually contains corticosteroids or other anti-inflammatory drugs to reduce inflammation. It may also contain an anaesthetic to relieve pain. Oral colchicine (pronounced: cole-chi-sene) and thalidomide may also help. These medicines are often used for sores on the genitals or in the mouth.
 
Inflammation of the joints related to Behçet’s disease is often treated with nonsteroidal anti-inflammatory drugs (NSAIDs– pronounced en-sedz) such as ibuprofen or ASA, or with steroids such as cortisone.  
 
Corticosteroids are useful for managing symptoms in early stages of the disease and for acute severe flares. Immunosuppressive drugs can be used to help reduce inflammation throughout the body, and to lessen the number of disease flares. Immunosuppressive drugs are usually used for Behçet’s patients who develop eye disease or central nervous system problems. Intestinal problems related to the disease may improve with sulfasalazine.

A Word about Medication Safety

The need to effectively monitor new drugs once they have been approved and introduced into the market has been a key advocacy issue for The Arthritis Society for several years. This advocacy helps to ensure that unfavorable side effects are reported, documented, and addressed. For regular updates on medications available in Canada, visit www.arthritis.ca/tips/medications.

All medications have potential side effects whether they are taken by themselves or in combination with other herbal, over-the-counter and prescription medications. It is therefore important for patients to discuss the benefits and potential side effects of all their medications with their doctor.

Health Canada’s Marketed Health Products Directorate (MHPD) has recently developed a new website, named MedEffect. MedEffect’s goal is to provide centralized access to new safety information about health products in an easy to find, easy to remember location. It also aims to make it as simple and efficient as possible for health professionals and consumers to complete and submit adverse reaction reports. Finally, it helps to build awareness about the importance of submitting adverse reaction reports to identify and communicate potential risks associated with certain drugs or health products. To find out more, visit: www.healthcanada.gc.ca/medeffect or call toll-free 1-866-234-2345.

Although rest is important during flares, doctors usually recommend moderate exercise, such as swimming or walking, when symptoms of the disease have improved or disappeared. 
 
Moderate stretching exercises can help people with Behçet’s disease keep the muscles and tendons around their affected joints strong and more flexible. Low-impact exercises like swimming, walking, water aerobics and stationary bicycling can all help you maintain strength and flexibility and increase your endurance.

The Cochrane Musculoskeletal Review Group (CMSG) is a specialized group of researchers and consumer representatives that belong to the Cochrane Collaboration, an international not-for-profit organization that encourages informed decisions about health care by preparing, maintaining and promoting reviews of the effects of various health care treatments.

CMSG members review the best available literature to determine the best evidence to support specific arthritis treatments. They explore the evidence for and against the effectiveness and appropriateness of treatments (medications, surgery, education, etc) in specific circumstances. The results are medical reviews that are then included in The Cochrane Library and made available to health professionals around the world.

For members of the public who also want to be informed about the evidence concerning health care practices and decisions in their lives, the Cochrane Musculosketal Review Group have summarized their reviews into consumer fact sheets. For the Cochrane consumer reviews related to ankylosing spondylitis, visit www.arthritis.ca/cochrane.

Along with the physical symptoms of Behçet’s disease, many people experience feelings of helplessness and depression. Learning daily living strategies to manage your disease gives you a greater feeling of control and a more positive outlook. To get the best results, people affected by Behçet’s disease need to form close ties with their doctors and therapists, and become full partners in their treatment. From our perspective, it's all part of 'living well with your disease.' There are several resources you can use to find out how best to manage your own condition.
Here are a few:

• The Arthritis Self-Management Program (ASMP) is a unique self-help program offered by The Arthritis Society to help you better control and manage your arthritis.
• The Open Forum within this website is an opportunity to discuss and share information with other visitors - people who, through their own experiences, may be able to offer some useful insights.

Of course, there are many other valuable resources for people with arthritis. If you're unclear about where to look for help, be sure to call The Arthritis Society at 1-800-321-1433.