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【单选题】
某女，50岁，2月前出现低热、乏力，后出现双腕关节、左手2、3、右手2指关节肿痛，晨起疼痛关节出现较长时间的僵硬，RF阳性。病人在联合用药治疗过程中出现了胃疼、纳差、黑便，应首先考虑的病因是（）A.
类风湿性血管炎所致
B.
原发性胃溃疡所致
C.
结核性结肠炎所致
D.
抗风湿性药引起的不良反应所致
E.
直肠癌所致
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