In summary, GI disease in RA can take on many forms, although the primary cause of GI manifestations at this time is iatrogenic. Physicians should be vigilant in their prescribing habits and carefully monitor patients on NSAIDs and DMARDs. In addition to this, healthcare providers should remain aware that RA is a chronic, multisystemic disease that does not manifest itself only in the articular surfaces. Bleeding, infarction, and perforation from primarily affected bowel sites should be considered on the differential diagnosis in the care of patients with RA, while hepatotoxicity and esophageal varices and dysmotility can occur either directly as a result of RA or as manifestations of rheumatic syndromes such as Felty's and Sjögren's, secondary to RA. Finally, it should be remembered that numerous diseases affect the GI tract and articular surfaces in close temporal relationship, and a careful history remains essential. © 2008 Elsevier B.V. All rights reserved.