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Ankylosing spondylitis is an autoimmune disease which affects collagen structures, specifically the joints between the vertebrae of the spine. The joints and ligaments that normally permit the spine to move become inflamed and stiff. The bones of the spine may grow together, causing the spine to become rigid and inflexible. Other joints such as the hips, shoulders, knees, or ankles also may become involved.
Incidence; Risk Factors
Symptoms of ankylosing spondylitis appear most frequently in young men between the ages of 16 and 35. It is less common in women, whose symptoms are often milder and more difficult to diagnose. About 5% of ankylosing spondylitis cases begin in childhood; boys are more likely to have it than girls.
The gene is present in 8% of white Americans and 2-3% of African Americans. About 1% of the adult population has this condition and, as expected, the disease is three times more common in whites than in African Americans.
Heredity seems to play a role in determining who if affected: approximately one in five sufferers have a relative with the same disorder. A gene called HLA-B27 that is present in over 90% of people with ankylosing spondylitis; of those who inherit the gene, 10-15% will fall victim to the condition.
Signs & Symptoms
When children develop ankylosing spondylitis, it usually begins in the hips, knees, bottoms of the heels or big toes and may later progress to involve the spine.
Diagnosis & Tests
Doctors usually base their diagnosis on symptoms and X-rays showing inflammation of the sacroiliac joints at the back of the pelvis. If symptoms or X-rays suggest ankylosing spondylitis but the diagnosis is uncertain, your doctor may perform a blood test to check for the HLA-B27 gene.
Treatment & Prevention
By watching posture and body position and by doing exercises daily, an individual can control many of the effects of the disease.
Prognosis; Complications
Almost all sufferers can expect to lead normal and productive lives. Despite the chronic nature of the illness, only a few people will become severely disabled; the management of pain and the control of inflammation can reduce the daily problems that may occur.
In extreme cases, the inflammation can cause the sacroiliac and vertebral bones to fuse or grow together. When this occurs, the normal flexibility of the spine, including the neck, is lost and the whole spine becomes rigid. Similarly, the bones in the chest may fuse, causing a loss of normal chest expansion when breathing. The hips, shoulders, knees, or ankles also may become inflamed and painful and eventually lose their mobility. The heels may become affected, making it uncomfortable to stand or walk on hard surfaces.
Ankylosing spondylitis is a systemic disease, meaning it can affect the entire body in some people. It can cause fever, loss of appetite, and fatigue, and it can damage other organs besides the joints, such as the lungs, heart and eyes. Inflammation can occur where the heart and aorta connect leading to possible enlargement of the aorta. Most often, however, only the lower back is involved.
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Signs, symptoms & indicators of Ankylosing Spondylitis:
Conditions that suggest Ankylosing Spondylitis: | | | | | Organ Health |  Iritis | The eye is the most common organ affected by ankylosing spondylitis. Iritis occurs from time to time in one-fourth of those with the condition. |
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Pain |
Low Back Pain| | The inflammation occurring in cases of ankylosing spondylitis usually starts around the sacroiliac joints i.e. the areas where the lower spine is joined to the pelvis. The pain is worse during periods of rest or inactivity, often awakening patients in the middle of the night. Symptoms typically lessen with movement and exercise. Over a period of time, pain and stiffness may progress into the upper spine and even into the chest and neck. |
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Skin-Hair-Nails |
Psoriasis |
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Risk factors for Ankylosing Spondylitis: | | | | | Autoimmune | Ulcerative Colitis |
Infections |
Bacterial Dysbiosis| | Intestinal overgrowth of an organism called Klebsiella plays a role in determining who is affected by ankylosing spondylitis and how severely. Research by doctors at King's College has uncovered a tissue similarity between this organism and the spine. In an autoimmune reaction to excessive amounts of Klebsiella, the immune system attacks the spine. Controlling this dysbiosis by diet reduces symptoms of the disease. |
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Ankylosing Spondylitis suggests the following may be present: | | | | | Infections |  Bacterial Dysbiosis| | Intestinal overgrowth of an organism called Klebsiella plays a role in determining who is affected by ankylosing spondylitis and how severely. Research by doctors at King's College has uncovered a tissue similarity between this organism and the spine. In an autoimmune reaction to excessive amounts of Klebsiella, the immune system attacks the spine. Controlling this dysbiosis by diet reduces symptoms of the disease. |
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Ankylosing Spondylitis can lead to: | | | | | Pain | Low Back Pain| | The inflammation occurring in cases of ankylosing spondylitis usually starts around the sacroiliac joints i.e. the areas where the lower spine is joined to the pelvis. The pain is worse during periods of rest or inactivity, often awakening patients in the middle of the night. Symptoms typically lessen with movement and exercise. Over a period of time, pain and stiffness may progress into the upper spine and even into the chest and neck. |
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Recommendations and treatments for Ankylosing Spondylitis: | | | | | Botanical, Chinese |  Lei Gong Teng| | Ankylosing spondylitis responded to TP (polyglycoside extract of Tripterygium wilfordii Hook F), sulfasalazine and methotrexate with effectiveness rates of 85%, 60% and 60% respectively after 6 months of treatment. In most cases treated with TP, alleviation was noted in symptoms of the spine and joints 2 weeks after starting the extract, and improvement in pain and swelling of joints and backache was observed 2 weeks later. [Chin Med J (Taipei) 1996; 57: S35] |
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Diet |
Grain-free Diet| | In an attempt to confirm a connection between Ankylosing Spondylitis (AS) and Klebsiella, doctors at Kings College introduced a low starch diet to AS patients, along with medication to control symptoms. Klebsiella thrives on a diet rich in starch. Without starchy carbohydrates such as rice, potatoes and flour products, the number of Klebsiella are reduced in the gut and, subsequently, so is the production of antibodies to the bacteria that cause the inflammation. Patients were instructed to cut out bread, pasta, cereals of all sorts, rice and potatoes as well as sugary foods. They were unrestricted in eating vegetables, fruit, eggs, cheese, fish and meat.
Over 200 patients have so far been through this program with the claim being made that the majority have had their disease process halted. One patient is quoted as saying "Once I stuck to the diet religiously, I noted a real improvement after six months or so. Movement became easier and the lethargy and depression lifted. The best way I can describe it is that after years of pain and stiffness I suddenly feel 'well-oiled'." |
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KEY | | Weak or unproven link |  | | Strong or generally accepted link | | | Proven definite or direct link | | | Highly recommended |
GLOSSARY
Antibody (Antibodies)
A type of serum protein (globulin) synthesized by white blood cells of the lymphoid type in response to an antigenic (foreign substance) stimulus. Antibodies are complex substances formed to neutralize or destroy these antigens in the blood. Antibody activity normally fights infection but can be damaging in allergies and a group of diseases that are called autoimmune diseases.
Autoimmune Disease (Autoimmune, Autoimmunity)
One of a large group of diseases in which the immune system turns against the body's own cells, tissues and organs, leading to chronic and often deadly conditions. Examples include multiple sclerosis, rheumatoid arthritis, systemic lupus, Bright's disease and diabetes.
Carbohydrates (Carbohydrate)
The sugars and starches in food. Sugars are called simple carbohydrates and found in such foods as fruit and table sugar. Complex carbohydrates are composed of large numbers of sugar molecules joined together, and are found in grains, legumes, and vegetables like potatoes, squash, and corn.
Chronic (Chronicity)
Usually referring to chronic illness: Illness extending over a long period of time.
Crohn's Disease (Crohn's)
Chronic inflammatory disease of the gastrointestinal tract. The most common symptoms are abdominal pain, often in the lower right area, and diarrhea. Rectal bleeding, weight loss, and fever may also occur. Bleeding may be serious and persistent, leading to anemia.
Immune System (Immune Response, Immunity)
A complex that protects the body from disease organisms and other foreign bodies. The system includes the humoral immune response and the cell-mediated response. The immune system also protects the body from invasion by making local barriers and inflammation. The process may involve acquired immunity (the ability to learn and remember a specific infectious agent), or innate immunity (the genetically programmed system of responses that attack, digest, remove, and initiate inflammation and tissue healing).
Iritis (Rheumatoid Iritis, Viral Iritis)
Inflammation of the iris, the colored part of the eye. Rheumatoid Iritis: An autoimmune (rheumatoid factor) inflammation of the iris. This is a face of rheumatoid arthritis seldom diagnosed, along with rheumatoid otitis. Viral Iritis: A viral infection of the iris. It appears red and swollen, and pupil contraction and relaxation is erratic and pulled. The usual cause is a herpes infection, often resident in the trigeminal nerve, and reoccurring during times of stress or sympathetic to a larger viral condition.
Pelvis
The lower part of the abdomen between the hip bones. Organs in a woman's pelvis include the uterus, vagina, ovaries, fallopian tubes, bladder and rectum.
Psoriasis
An inherited skin disorder in which there are red patches with thick, dry silvery scales. It is caused by the body making too-many skin cells. Sores may be anywhere on the body but are more common on the arms, scalp, ears, and the pubic area. A swelling of small joints may go along with the skin disease.
Spondylitis
Inflammation of one or more vertebrae.
X-rays (X-ray)
High-energy radiation used to take pictures of areas inside the body.
Last updated: May 04, 2008
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