Reiter's syndrome begins with a bacterial infection in the gastrointestinal or urogenital system. The gastrointestinal bacteria can enter the body through eating or handling contaminated food. It may produce symptoms of fever, diarrhea, vomiting and abdominal pain.

In the urogenital system, bacteria such as chlamydia are transmitted through unprotected sexual contact and may produce pelvic pain or sexual pain. Men and women may experience pain or burning during urination (dysuria). Abnormal discharges, from the penis in men and the vagina in women, may also appear. However, many people experience no symptoms from chlamydia.

If the initial bacterial infection progresses to Reiter's syndrome, the person may experience symptoms two to four weeks after the first infection. Symptoms may include:

• Urogenital symptoms in men (inflammation of the urethra or prostate gland - urethritis or prostatitis):
  
  
• • Burning sensation during urination
  • Increased urges to urinate
  • Unusual discharge from the penis
  • Chills and fever
  • Sores on the penis
    
    
• Urogenital symptoms in women (inflammation of the urethra or cervix - urethritis or cervicitis):
  
  
• • Burning sensation during urination
  • Increased urges to urinate
  • Abnormal vaginal discharge
  • Bleeding between menstrual periods
    

Some women can also develop inflammation of other reproductive organs that may produce no symptoms. These include salpingitis (inflammation of the fallopian tubes) or vulvovaginitis (inflammation of the vulva and vagina).

• Joint symptoms:
  
  
• • Pain or swelling, commonly in the knees, ankles, feet, lower back or hands.
    
    
  • Sausage digit. A finger or toe that is red and swollen for its entire length.
    
    
  • Inflammation of tendons (tendinitis), especially the Achilles tendon in the lower leg.
    
    
  • Enthesitis. Inflammation and pain where the tendons connect to bones.
    
    
  • Heel and foot pain. Including heel spurs and growths on the bones on the bottom of the foot.
    
    
• Eye symptoms:
  
  
• • Conjunctivitis. Eye pain, redness and swelling of the conjunctiva, the mucous membrane that lines the eye and inside of the eyelid. It may involve one or both eyes.
    
    
  • Uveitis. An inflammation of the uveal tract, the middle layer of the eye.
    

    

These three areas of symptoms (genitals, joints, eyes) define Reiter’s syndrome. Some patients also develop other symptoms of reactive arthritis, including buttock or lower back pain, scaly rash on the penis, red or brown spots on the palms or soles of feet and sores in the mouth or on the genitals.

The symptoms of Reiter's syndrome may flare up for several months and resolve with treatment. Some people may experience recurrence of the joint pain or other symptoms. Recurrence of the arthritis symptoms is much more common when Reiter's syndrome originates from a urogenital infection.