Ankylosing Spondylitis
Concept and types of Ankylosing Spondylitis
ankylosing spondylitis (abbreviated EA), ankylosing spondylitis or ankylosing spondylitis is a chronic inflammatory disease of unknown cause is included in the spondyloarthropathies (group of similar diseases in some of its clinical features, association with the histocompatibility antigen HLA-B27 in certain radiological features, response to treatment, etc). These include diseases such as spondyloarthropathies, Reiter's syndrome , psoriatic arthritis and spondylitis, juvenile spondyloarthropathies , reactive arthritis, arthritis and spondylitis enteropathica, etc. These diseases are "seronegative" , without the presence of rheumatoid factor , as distinguished from rheumatoid arthritis . They are diseases that are usually located in the enthesis , or area where the bone is inserted into the joint capsule, ligaments or tendons, affecting to a greater or lesser extent to the spine and peripheral joints . They also often appear phenomena fibrosis and ossification with new bone formation and causing what is known as ankylosis.
These two words, "spondylitis" and "ankylosing" refers to a process of spinal fusion, as vertebra and ANKYLOS spondylo obviously means "ankylosis" ( can also read the history of ankylosing spondylitis) . Therefore indicates that this is primarily a disease of vertebral involvement (which affects the axial skeleton ). However, within its wide range of clinical manifestations also includes other as those previously mentioned peripheral joints (hips, knees, jaw, chest, etc) or events beyond the joints, problems such as aortic or eye uveitis, or other less common phenomena. However, the serious and disabling consequences of this disease have been declining gradually with the use of pharmacological treatments and patient and physician awareness of the importance of the person concerned make exercise controlled by your doctor and change their habits, if necessary, by other more healthy.
is considered that the disease most often affects men (in a 3:1 ratio compared to women) and usually appears in the second and third decade of life, but also appear processes that start in adolescence and is considered juvenile ankylosing spondylitis, as they appear below the barrier of 16 years . This type of spondylitis is characterized by increased frequency of involvement of peripheral joints, especially knees and hips with significant presence of enthesitis
Not only are there two forms of presentation of the disease. Ankylosing spondylitis is a disease of difficult diagnosis for at least the beginning, since in many cases they refer back pain patients, or pain in thighs etc. not a specific symptom that leads to talk of spondylitis. So many times patients are desperately waiting for a definitive diagnosis. This helps sometimes these patients did not show positivity for HLA-B27 , in this case, patients usually have a better evolution being its lower peripheral involvement with the incidence of uveitis .
Therefore, ankylosing spondylitis is a disease whose severity is relative. The patient's effort to avoid falling into the physical neglect, good control of the physician and the unpredictable behavior of the disease are factors to take into account the daily lives of people who suffer. Whenever possible you have to perform the exercises tables and try to see the disease as something that we must live our entire lives, with the primary objective that the quality of life not being eroded. Drugs, exercise and the degree of clinical aggressiveness of spondylitis are the three things we should value those who suffer and can act on two of them.
Epidemiology and frequency of ankylosing spondylitis
The epidemiology is a science that studies the diseases from a mathematical perspective, the frequency or incidence of a disease, which may be important factors in its appearance (Race, sex, age, etc..) And all aspects can be assessed. Therefore has a very important statistic. 
research ankylosing spondylitis has an important role in HLA-B27 (histocompatibility antigen) . Their presence does not indicate that a person has or will suffer from spondylitis, but in case there are certain symptoms and radiological signs is an indicator that can contribute to definitive diagnosis. The prevalence or frequency of occurrence of this antigen is 7% of those studied (although as a curiosity, there is a tribe of Indians whose positivity rate is 50% B27, and spondylitis in the same population is around 5%). However, not all these people have the disease. Be positive for HLA-B27 (positive amounts to be present in our body that antigen) is a probability of 1 to 2% of suffering, although the probability would rise to 10-20% if we are positive and there is also a family first grade already have it. The interesting thing is that about 95% of people with spondylitis white positivity of HLA B27, so what you are looking to establish the relationship between their presence and development of the disease. In other races other than white the relationship with HLA-B27 is not as tight.
Figures spondylitis also have to be treated with caution as there are cases of people living without being diagnosed because the disease is mild, etc.
Suffice it to say that the association with HLA-B27 is independent of the severity of the disease and that the issue of HLA-B27 is much more complicated than it seems, because no single HLA-B27, but subtypes. Anyway, today it is widely tested for antigen it helps the doctor to guide the diagnosis to be present in most people with spondylitis. However, as commented in the section on types of spondylitis there are individuals who do not have this HLA yet develop the disease, but it seems that with less severity.
As for the distribution of disease by gender, the imbalance is 2 or 3 men for every woman around.
It must be said that there is some association between spondylitis and inflammatory bowel disease (ulcerative colitis and Crohn's Disease). In fact inflammatory bowel disease is a risk factor spondylitis independent of HLA-B27, although 50-75% of patients with both processes are positive for the HLA. Etiopathogenesis
: causes and processes involved in Ankylosing Spondylitis
The pathogenesis is a term that refers to one side to the etiology or cause, in the case of spondylitis is still unknown, and moreover the pathogenesis (or abnormal pathological processes that cause the deterioration of ankylosing spondylitis).
The patient must have a certain "willingness" to have the condition (which would be the genetic component, related to inheritance) and should also be a trigger factor or is influenced decisively the development of the disease. Should therefore be clear that spondylitis is a disease much less contagious. The probability of inheriting under study, but as I mentioned in the section spondylitis epidemiology of risk for dementia when first-degree relatives are affected is much greater than the risk that the rest of the population.
We can find immune components, association with HLA-B27 and a typically inflammatory pathology. It is not known what specific process or exogenous agent may precipitate the disease, but findings have been made and found some relationship with Klebsiella pneumoniae . Some studies suggest that patients with AS presented higher amounts of antibodies against the bacteria. We must also remember the relationship between spondylitis and Inflammatory bowel . Still, because some individuals are not positive for the B27 and have the disease, can not make a conclusive statement.
Then there's the role of the HLA-B27. Positivity in an individual (about 6-7% of the population) does not mean that it will develop the disease, because of them only a small portion (1-2% of positives) will suffer the disease. The risk would increase to 20% if a family member has spondylitis. You have established 12 different variants and subtypes of HLA-B27 Ag, since it is a polymorphic gene that would encode these variants. The most commonly associate with the disease are the B2702 and B2705.
In this disease there is an autoimmune process that affects our joints. Our own immune system (whose main mission is to keep our body safe from infection or malignancy), "assaults" the joints. What is studied not only the causes but also the mechanisms. Able to "design" drugs that may block these mechanisms allows the disease, while not cured, do not alter our joints. Until the day you locate the causes and trace the basic outline of cure, we must rely these drugs that keep our quality of life as close as possible to normal.
Clinical manifestations and complications of
Ankylosing Spondylitis Ankylosing spondylitis primarily affects the spine, gradually. The tendency is to ankylosis, but this is not always complete because the evolution of the disease is unpredictable. In some people behave kindly and in others the process erodes the spinal joints for years causing a serious disturbance of functionalism spine. However
spondylitis is not limited to the involvement of the spine, as in some patients, especially those in which the disease begins before age 16 and therefore considered to have a juvenile ankylosing spondylitis . In fact, this form of youth involvement is often associated with more severe cases of spondylitis for various reasons. One is that these people are subjected to the inflammatory processes of the disease over time, coupled with this is the ingestion of drugs during much of life (with the possible side effects) and also seen in some studies on juvenile ankylosing spondylitis that the impact on the involvement of peripheral joints (hips, knees, etc..) is higher than what we might consider adult ankylosing spondylitis.
So how are the early ankylosing spondylitis? The onset of the disease is usually between 20 and 40 years, but as I said, there are cases and cases of juvenile onset above 40 years but not more often. These people have soreness persistent and insidious but nonspecific, frequently in the lower back and even in the buttocks, which suggests a low back pain and therefore do not see a doctor. It is characteristic lumbar stiffness in the morning, it will be several hours and yield to the exercise but returns if the person remains immobilized for some time in the same position. The pain tends to become more cumbersome and lengthy, sometimes referring to discomfort in the thighs, is bilateral and may affect people's sleep of the person, leading sometimes to have to get up at night to "conquer" the rigidity that annoying after a while sleeping. The doctor may find tenderness at the level of the buttocks, which can do suspect of involvement of sacroiliac , as are these joints of the lower or caudal vertebral column which usually take the first clinical evidence to guide physicians towards the definitive diagnosis. As you can see, it is not easy for the physician to make the diagnosis of spondylitis since it has some clinical features, at least in the beginning, that clearly distinguished from other diseases affecting the spine.
Another problem is that sometimes occurs initially spondylitis affecting the heel, tibial tuberosity, ischial tuberosities, femur, iliac crest, spinous processes even at sternocostal.
Once the doctor diagnosed spondylitis and treatment is started (which in this disease have not been located yet its cause , type is mainly symptomatic and not curative) the symptoms of patients suelenmejorar and this, coupled with relief that at last I know is that we suffer, leading to confront the disease better prospects. It is also characteristic of spondylitis outbreaks ongoing in considering an outbreak as a period of undefined length of time during which the disease manifests greater activity, which is a reflection of the inflammatory processes, which will be increased.
or clinical symptoms that appear on spondylitis more often are
sacroiliitis: Inflammation of the sacroiliac joint is relatively common in the early stages of the disease. It is situated in the bottom of the spine, in relation to the hip bone, which structures our hips. The diagnosis the presence of sacroiliitis on imaging tests (magnetic resonance imaging and X-ray) is an indicative sign spondyloarthropathy. The sacroiliac pain is not necessarily confined to that region, it is sometimes referred to in the back of the thigh, even to the knee. Pain is usually bilateral (Bilateral sacroiliitis) and can jump from one to another sacroiliac. Because eventually suffer this joint ankylosis (lose its functionalism) the patient will no longer have pain in the area. Where it exists, can be increased with the efforts which lead to the tension in the area, such as sneezing and coughing .
Spine: In the initial stages will be pain in the lower part of the same, at the low back. But as time passes will gradually ascending, and the pain moved to different segments. The pain is insidious, especially sleep occurs after, after periods of rest in the same position and it is not surprising that interferes with nighttime sleep. Something too often, pain when coughing and sneezing. This pain will not be associated with greater or lesser effort of the patient, and often have periods of remission. If the disease progresses, laa column is losing mobility over time, especially flexion-extension movements back and sides by the lumbar spine. Another important aspect is that respiratory movements may be limited. The doctor usually measured (by Schober test ) the degree of flexion of the lumbar spine and range expansions chest. The severe and untreated cases have to make lumbar lordosis (normal inclination of the spine at that level) the loss, atrophy of paraspinal muscles and buttocks, and thoracic kyphosis increases. When it affects the cervical spine (column in its upper part, which relates to the base of the skull), often bending the neck forward. Another phenomenon that can happen is that the subject lost some stature as the disease evolves, but not dramatically, due to the inclination of the column. It also increases the distance between occiput and wall when we stand with their backs against a wall (we speak of forestier arrow) For ankylosis women should be lower, but usually have more cervical ankylosis and peripheral involvement.
peripheral joints: Most patients can manifest at some point in their lives with some alteration in the form of peripheral joint inflammation. Even in some cases are the main cause of discomfort in the early periods of the disease. As for the features of this assignment, I must say that is not usually bilateral and most often it is oligoarticular and lower limb, stressing the juvenile spondylitis in As for the presence of these manifestations. Affected joints are usually: hips, knees, ankles, shoulders, and also spoken in some texts of tarsal and metatarsophalangeal. The most common are the hips, the patent being limited movement and pain when they are affected. In this case, usually affecting both sides (bilateral). In principle it should be self-limiting, but sometimes you need a special treatment to curb the swelling and not too damaging elements that form a joint; methotrexate, anti-tnf , sulfasalazine , steroids, etc.. are some of the drugs we sometimes prescribe the doctor if we are in this unpleasant situation but fortunately usually refer to treatment with these drugs.
Chest: existem When coughing or sneezing may appear significant pain, sharp and almost immediately gave, which is due to the involvement of the joints in the area, which are the manubrium-sternal chondro-sternal and sterno-clavicular, as a result of this inflammatory process in ankylosing spondylitis. Patients can develop over time a abdominal breathing for chest movements, if these joints affected, tend to be increasingly less broad and flat chest.
Complications and Extra-articular manifestations: are those diseases that occur away from the joints are less frequent and are considered complications of the disease. Click to view the article on the complications of ankylosing spondylitis
Diagnosis and exploration in Ankylosing Spondylitis
The early diagnosis of any disease is one of the goals of medicine. To detect a disease when it is still beginning to produce alterations in all cases is incalculable benefit to the patient.
In the case of ankylosing spondylitis, this benefit is increased substantially if we consider that the majority of patients have a certain time (which can sometimes last for a few years) suffering from the disease. For both the diagnosis and know "what I have," is fundamental to any person, not only physically but psychologically.
But also we have seen that early diagnosis of spondylitis is long-term improvements, allowing the patient to develop and practice behaviors exercises that will allow adecuadar keep the functionality to not be struggling in their daily lives. The beginning of pharmacological treatment is also positive because symptoms often fade and the patients feel more willing to engage.
As you have read the section signs and symptoms of ankylosing spondylitis early diagnosis is complicated by the absence of a symptom or sign to indicate precisely the person has spondylitis. So doctors have developed criteria for determining when it is a spondylitis. The most common criteria are the New York 1984, modified:
1. back pain history of inflammatory nature of 3 months least, that improves with exercise and worsens with rest.
2. limitation of movements of the lumbar spine in the frontal and sagittal planes
3. Limitation of respiratory excursions in relation to normal values \u200b\u200bin response to age and sex.
4. radiographically defined sacroiliitis .
is considered that the presence of radiological sacroiliitis (Also used the MRI with very good results - see photo) plus one of any of the other two criteria is sufficient to diagnose ankylosing spondylitis. This sacroiliitis is often bilateral (affecting the left and right sacroiliac joints), 
Something that is so fundamental is the differential diagnosis, ie to distinguish between spondylitis and other diseases that, at least initially, may confuse the diagnosis. Thus it is said that the pain spondylitis presents a typical five (Calin criteria):
* Pain is below 40 years
* Is the pain of insidious onset
* Lasts longer 3 months of before you visit your doctor
* It is clear the morning stiffness
* Improves with exercise and activity
Thus, it narrows a little more field. Furthermore, the disease responds very well to nonsteroidal antiinflammatory drugs (NSAIDs) , although this is not a diagnostic criterion, only a clue if the person responds well to the administration of these drugs. Therefore 
This is done using a series of imaging , analytical etc. Click here if you want to know these tests.
Forecast and Evolution of ankylosing spondylitis
The prognosis of ankylosing spondylitis has improved because every time you get a prompt diagnosis and also provides of drugs increasingly effective to curb inflammatory processes. But the disease still has no cure yet known for the agent or agents thereof.
As you know, the disease does not even behave the same way in people who have it. Their age of onset is variable, the way is also presented, and its evolution is unpredictable. However no data for optimism. The fact of having spondylitis does not mean that a mandatory will suffer all the changes that are associated with the disease, so not worried because although we live is a disease that causes a daily annoyance, it is unbearable.
There are people who suffer a more severe spondylitis, which causes damage in peripheral joints and long term can damage organs, but they are a smaller percentage. As an example, there is also people who die from flu. So the first thing is not alarmed. The doctor can not tell what will happen to us, but we advise what we can do things for the disease to deteriorate us as little as possible.
Most patients with spondylitis make a normal life it is a life that sometimes petty actions cost us something more than physical labor, but that does not mean, let alone that a person is going to be in a wheelchair. In fact, being a disease that tends to take on shoots, often appear long periods of time not determined, in which the person will be feeling well and the pain will be lessened. Therefore we must never forget that the progression of ankylosis is variable and who knows if you can send, at least for a while.
have been made to follow patients and manifests the appearance of ankylosis occurs in less than half of the cases and nearly everyone maintained an acceptable functional capacity. Especially valued first 10 years of disease to account progression, it is when the disease presents his "credentials" in terms of vertebral involvement. The age of onset before 16 years, the degree of vertebral limitation, the poor response to anti-inflammatories, and the fact that it is a sporadic spondylitis (no affected relatives), data represent the worst prognosis.
Another problem is the side effects of treatment , but this doctor will perform regular checks as blood tests and urine , etc. to determine whether they are harmful to your body at some point.
So now day prognosis of patients with EA is better, because the diagnosis is made more early and improve treatments every day, so we must be optimistic about the future of this disease.
Treatment of Ankylosing Spondylitis
In the treatment of ankylosing spondylitis play a fundamental role gymnastics and physical therapy to maintain joint mobility and prevent gradual deforming of the spine (kyphosis ), even where the exercise can be painful for the patient concerned. Especially recommended are stretching exercises, like Yoga or Pilates. The basic treatment is the sulfasalazine (Salazopyrina) or sulfapyridine, immunomodulatory drug that reduces inflammation in joints. Since 2003 there are the so-called "biological" as the Infliximab (Remicade) and Etanercept (Enbrel) , belonging to the family of Anti-tumor necrosis factor (anti-TNF) , and reduce inflammatory processes. Also, the Adalimumab (Humira) , the first fully human monoclonal antibody, may decrease the signs and symptoms, inducing major clinical response in patients with active ankylosing spondylitis. The Adalimumab (Humira) specifically binds to tumor necrosis factor TNF alpha, but not to lymphotoxin (TNF-beta)) and neutralizes the biological function of this by blocking its interaction with p55 and p75 receptors for TNF in the cell surface. With these drugs, at present very expensive, we have obtained very good results, although there are no long-term studies to ensure its safe use. Prior to his appearance were used NSAIDs Non-steroidal anti as indomethacin , Tolmetin (artrocaptin) , Methotrexate and COX 2 etoricoxib (Arcoxia) to reduce pain and control processes Protective gastric inflammatory. There are also studies that mention treatment with pamidronate (Aredia, Pamifos) , Thalidomide and the radioactive isotope 224 radio. In advanced cases there is also a surgical solution in which the vertebrae are fractured acquired stiffness and re-attach in the proper position with metal plates. This operation is complicated and not a little risk but can greatly improve the quality of life of patients.
corticosteroids or glucocorticoids
Each person will receive a treatment individual, and sometimes it may be months until it gives the appropriate drug or dose. In addition there may come a time when a drug is no longer effective. Therefore, for their own health, not make decisions about their illness without first talking to your doctor.
Physiotherapy and exercises ICIO
Exercise is one of the basic pillars that should support the person with ankylosing spondylitis. Regulated financial tables and supervised by your doctor are something you should hold on tightly, because these exercises allow us to maintain the smooth functioning of our joints. Not everything is "taking drugs" but you have to put something on our part to improve our fitness. Spondylitis has the advantage of allowing sports, yes, as you warn your doctor, sports are not recommended, especially those where physical contact plays an important role because of injuries in a person with spondylitis (mainly back) are not equal to the injury of a person without disease. Yet many people who, due to spondylitis is benevolent, continue to enjoy the sports they normally. Daily sports news we spondylitis, mixed with ignorance and lack of many media. Probably the athlete is unable to continue competing at the same level, but in no way going to be in a wheelchair. So your mind away from the drama and get to work. Ask your doctor about exercises you can do or if you wish, ask to review I have included in the web, courtesy of AVIDEPO and a member of EDEP . If you want you can download AVIDEPO exercises and "Patient's Guide" in the Download Zone
AVIDEPO: Exercises column or spine AVIDEPO: rib mobility exercises and abdominal
AVIDEPO: Exercise ventilatory
EDEP: Cervical Spine Exercises EDEP: Exercises spine
EDEP: lumbar spine exercises
EDEP: Breathing exercises
Alternative Therapies: Alternative Medicine
balneotherapy: HEILSTOLLEN Gastein Spa (AUSTRIA)
is a resort in Austria with unusual environmental conditions. After a trip through the mountains central Europe will find an environment that includes:
- radon gas, which itself is radioactive (albeit a very mild form of radioactivity, and in this place there are higher rates of cancers in other parts of Austria).
- air temperature of 37.5 ° C-41.5 ° C
- humidity between 70% and 90%
These conditions would be similar to a sauna in a medium slightly radioactive.
The people attending the spa Spondylitis improvement in terms of functionality, comfort and less morning stiffness compared with people staying at home only with the normal treatment. This improvement is 40 weeks after the spa Austria, which exceeds the 16 weeks of the improvement in people attending a normal spa (including exercise and hydrotherapy). It therefore seems advantageous in the long run when visiting this Austrian resort Heilstollen. For more information please visit http:// gasteiner-heilstollen.info/dt/d1 / Before you call must be referred by a doctor. References
:
van Tubergen A, Landewe R, van der Heijde D, Hidding A, Wolter N, Asscher M, Falkenbach A, Genth E, The HG, van der Linden S. Combined spa-exercise therapy is Effective in Patients with ankylosing spondylitis: a randomized controlled trial. Arthritis Rheum 2001, 45 (5): 430-8.
ACUPUNCTURE
Acupuncture has been used for a long time alongside traditional medicine to alleviate symptoms of arthritis. It is a traditional Chinese medicine in which thin needles are inserted at specific points believed to represent a position of all energies of the body. In some cases adding a small electrical pulse to needles (electroacupuncture). Once the needles are inserted at some appropriate point in the release morphine-like substances (morphine-like substances) to the patient's circulation, inducing a local or general analgesia.
Tests have been conducted in patients arthritis (osteoarthritis and rheumatoid arthritis), studying and comparing effects among those who have used this therapy and who have not used. The results from these studies suggest that acupuncture may help reduce pain (especially electro) but does not improve functionality. The general recommendations of these studies is that acupuncture can not be recommended as a treatment for arthritis as the improvement has been seen is very short and some of the improvements may be due to a significant placebo effect. However, it was found that electroacupuncture is effective when used in laboratory rats. The rats showed a recovery of 40% for a short period of time (Similar to the recovery seen when injected with a substance that suppresses the pain.) The improvement was not seen when acupuncture was applied in the wrong place in the rat paw.
The bee venom acupuncture is more effective.
Therefore, in summary, acupuncture may help reduce the pain for a short period (eg 24 hours) but does not alter the course of the disease and reduce inflammation.
REFERENCES:
Ferramdez Infante A, Garcia Olmos L, Gnzalez Gamarra A, Meis Meis MJ, Sanchez Rodriguez BM. Effectiveness of acupuncture in the Treatment of Pain from osteoarthritis of the knee. Aten Primaria 2002 30 (10): 602-9. Koo ST, Park YI, Lim KS, Chung K, Chung JM. Acupuncture analgesia in a new rat model of ankle sprain pain. Pain 2002; 99 (3): 423-31. Casimiro L, Brosseau L, Milne S, Robinson V, Wells G, Tugwell P. Acupuncture and electroacupuncture for the treatment of RA. Ezzo J, Hadhazy V, Birch S, Lao L, Kaplan G, Hochberg M, Berman B. Acupuncture for osteoarthritis of the knee: a systematic review. Arthritis Rheum 2001; 44(4):819-25 Kang SS, Pak SC, Choi SH. The effect of whole bee venom on arthritis. Am J Chin Med 2002;30(1):73-80
SULFATO DE GLUCOSAMINA
La Glucosamina es un derivado natural de la glucosa, producida por las células, y es una parte esencial dentro de glycoproteins and proteoglycans, which helps build proteins. Commercially, glucosamine is sold over the counter to relieve arthritis. Although there is evidence for the benefit of using glucosamine, the mechanism is unknown. It is thought that glucosamine stops the signal originating many of the chemicals involved in inflammation. This means you may have immunosuppressive effects (decrease in the activity of some systemic immunological and inflammatory mechanisms, involved in arthritis and ankylosing spondylitis). However, people who are sensitive to insulin should be aware that sugar is glucosamine.
Research on of glucosamine and arthritis has been mainly in osteoarthritis and ankylosing spondylitis not. The findings of these studies have suggested that glucosamine is effective and equivalent to ibuprofen. In a 3-year study in patients with knee osteoarthritis, few of those taking glucosamine sulfate had severe knee involvement (ie, radiological damage visible), symptoms and improved joint function in patients Glucosamine sulfate is added. The long-term treatment with glucosamine slows the progression of knee arthritis.
have seen that glucosamine is equivalent or superior to anti-inflammatory drugs normal for the treatment of osteoarthritis. Therefore, it can be used in this disease together with normal anti-inflammatory. An important advantage in the use of glucosamine is to help repair joint elements in knee osteoarthritis, ankylosing spondylitis, but this benefit is not as vital. References
:
Pavelka K, Gatterova J, Olejarova M, Machacek S, Giacovelli G, Rovati LC. Glucosamine sulfate use and delay of progression of knee osteoarthritis: a 3-year randomized, placebo-controlled, double-blind. Arch Intern Med 2002 Oct. 14, 162 (18) :2113-23 L-Mom, Rudert WA, Harnaha J, Wright M, Machen J, Lakomy R, Qian S, Lu L, Robbins LB, Trucco M, Giannoukakis N. Immunosuppressive effects of glucosamine. J Biol Chem 2002 Oct. 18, 277 (42) :39343-9 Ruane R, Griffiths P. Glucosamine therapy compared to ibuprofen for joint pain. Br J Community Nurs 2002 March, 7 (3) :148-52 Noack W, Fischer M, Forster KK, Rovati LC, Setnikar me. Glucosamine sulfate in osteoarthritis of the knee. Osteoarthritis Cartilage 1994 March, 2 (1) :51-9 Towheed TE, Anastassiades TP, Shea B, Houpt J, Welch V, Hochberg MC. Glucosamine therapy for treating osteoarthritis. Cochrane Database Syst Rev. 2001; (1): CD002946 Reginster JY, Deroisy R, Rovati LC, Lee RL, Lejeune E, Bruyere O, Giacovelli G, Henrotin Y, Dacre JE, Gossett C. The long-term effects of glucosamine sulphate on osteoarthritis progression: a Randomised, try (trial), placebo-controlled clinical. Lancet 2001, January 27, 357 (9252) :251-6
DIET and ankylosing spondylitis
Half of the people who follow specific diets have less pain and stiffness. Some people with ankylosing spondylitis have proven periods of fasting and 2 in 3 people reported less pain and stiffness. However, there are very few published studies examining diet and Reducers symptoms of arthritis.
The theory of these diets are based on studies that have linked to bacteria as the "trigger" that initiates the ankylosing spondylitis, with the location of this bacteria intestine. However, once the disease is not clear that the presence of the bacteria may be associated with greater severity of illness. It is thought that people with ankylosing spondylitis has a small "peculiar" that allow the passage of bacteria or other particles that could be aggravating factors of the disease. It has been suggested that if you do not take food that you "like" bacteria, could get rid of most of them, which would improve their condition. It was published a study in 1996 that suggested a diet low in starch (which means no bread, potatoes, cakes, pastries, etc..) could relieve symptoms of ankylosing spondylitis. However, no further studies have been published to confirm this finding.
could be argued in reference to this diet may notice a temporary benefit if you change your diet radically (ie, eating fish and not eating meat, beef or stop and just take starch). Changing your diet means changing the intestinal bacteria. However, it is likely to return after this time his symptoms of ankylosing spondylitis with the establishment of new bacteria in your gut.
DANGEROUS DIETS: radical diets that reduce nutrition and essential vitamins should not be considered. It is possible that a radical diet may reduce symptoms of ankylosing spondylitis as it to be effective immune response requires a good general. If you lack certain minerals and vitamins will not be able to generate an immune system that defends the body against infections and other processes. Therefore, even in ankylosing spondylitis the immune system and inflammation are factors that are detrimental to our body, its general functions are vital to keep alive and dangerous these diets can cause ankylosing spondylitis pass background, but the emergence of more serious illnesses.
AN ALTERNATIVE: Use a "friendly bacteria" (like the ones today are used in some yogurts and dairy products) can help eliminate those foods that are harmful to arthritis, however, research in this plane is very limited and it is unclear benefit can be achieved with these foods.
SUMMARY: There are very few published studies that support this theory that symptoms improve with a certain diet. It is unlikely that the bacteria that can trigger the EA is involved in processes that get worse. Things that generate spondylitis not appear to be influencing them to make it milder or more severe. People from countries like Alaska, where diet is mostly protein and little starch, no disease characteristically smooth.
However, if a person notices the benefits and low starch diet has been monitored by her doctor and considered to be safe, no reason to stop using low-starch diet.
References:
Haugen M, Kjeldsen-Kragh J, Nordvag B lining O. Diet and Disease Symptoms in rheumatic diseases - results of a questionnaire based survey. Clin Rheumatol 1991, 10 (4): 401-7. Vaile J, Meddings J, Yacyshyn B, Russell A, Maksymowych W. Bowel permeability and CD45RO expression on circulating CD20 + B cells in Patients with ankylosing spondylitis and their relative. J Rheumatol 1999; 26(1): 128-35. Elbringer A, Wilson C The use of a low starch diet in the treatment of patients suffering from ankylosing spondylitis. Clin Rheumatol 1996; 15 (Supp 1): 62-66. Kanauchi O, Mitsuyama K, Araki Y, Andoh A. Modification of intestinal flora in the treatment of inflammatory bowel disease. Curr Pharm Des. 2003; 9 (4): 333-46.
