ankylosing spondylitis treatment diet

Ankylosing spondylitis treatment diet & permanent cure for ankylosing spondylitis

Ankylosing spondylitis definition

Ankylosing spondylitis (AS) is a chronic inflammatory condition (also known as axil spondyloarthritis) that often affects the joints in your spine, rib cage and pelvis, and bones of affected joints may develop fused. This disorder allows for less flexibility in the spine.  

In males, the occurrence is greater than in females, and symptoms are more pronounced in males, with ascending spine involvement more likely to occur. Ankylosing spondylitis often runs in families.

Ankylosing spondylitis age of onset,  the age at onset is usually in the late teens or early 20s.

Ankylosing spondylitis differential diagnosis

Rheumatoid arthritis, ankylosing spondylitis, primarily affects the numerous, small, peripheral joints of hands and feet. The sacroiliac joints are spared by rheumatoid arthritis and affect only the cervical part of the spine.

Bilateral sacroiliitis indistinguishable from ankylosing spondylitis is seen with the inflammatory bowel disease (IBD) related spondylitis.

Sacroiliitis associated with reactive arthritis and psoriasis, on the other hand, are often asymmetric or even unilateral. 

Osteitis condensins ilii (sclerosis of the sacroiliac joint on the iliac side) is an asymptomatic, postpartum radiographic result that is often mistaken for sacroiliitis.

Diffuse idiopathic skeletal hyperostosis (DISH) causes exuberant osteophytes ("enthesophytes") of the spine that occasionally is difficult to distinguish from the syndesmophytes of ankylosing spondylitis.

 

DISH enthesophytes are thicker and more anterior than ankylosing spondylitis syndesmophytes, and in DISH, the sacroiliac joints are regular.

Ankylosing spondylitis symptoms

The pain of ankylosing spondylitis usually occurs in the morning, during the night or after periods of inactivity. 

If a person faces stiffness in the lower part of the wait for more than an hour after getting up in the morning, then this could be the initial stage of ankylosing spondylitis.

• Low back pain, the most common symptom of ankylosing spondylitis is spinal pain. Initially, the pain is in the lower back,  which also affects the hip bone and joint, then gradually goes up through the spine, then it comes in the middle and then it also involves neck nerves.

• Stiffness in the back, it is difficult to bend, especially after waking up in the morning.

• Sleep disturbances  (Ankylosing spondylitis causes frequent sleep disturbances and difficulty in changing the crotch.) 

• Low-grade fever  

• loss of appetite  

• Chronic diarrhoea (IBD can be associated with ankylosing spondylitis)

 In comparison to back pain due to mechanical causes and degenerative disease, which improves with rest and worsens with exercise, the pain and stiffness increase with exercise.

As the disease progresses, symptoms develop in the direction of the cephalad, and back motion becomes reduced, with the usual lumbar curve flattened and the curvature of the thoracic exacerbated. Because of the costovertebral joint involvement, chest expansion is often reduced.

The entire spine becomes fused in advanced cases, allowing no motion in either direction. Transient acute arthritis of the peripheral joints occurs in around 50% of cases, and permanent improvements in the peripheral joints are most often seen in the hips, shoulders and knees, about 25%.

Enthesopathy, a symptom of spondyloarthropathy may manifest as swelling of the Achilles tendon when inserted, plantar fasciitis (Triggering heel pain), or "sausage inflammation of the finger or toe" (less common in ankylosing spondylitis than in psoriatic arthritis).

 

Anterior uveitis is connected in as many as 25 percent of cases, and maybe a function of appearance. 

Spondylitic heart disease, which is primarily characterized by atrioventricular conduction abnormalities and aortic regurgitation, occurs in 3-5 percent of long-standing serious disease patients. Constitutional signs are missing in most patients, close to those with rheumatoid arthritis.

Ankylosing spondylitis causes

The cause of ankylosing spondylitis is unknown, but some precautions can be taken to prevent this painful disease, but to avoid ankylosing spondylitis flare-up you should follow some healthy habits, like,

•  Weight control  

• Morning and evening walk  

• Don't lift too much weight  

• Avoid smoking and alcohol  

• Should take a bath with lukewarm water 

There are many risk factors of ankylosing spondylitis, of which sex, age, more inactiveness, more exertion and genetic are considered very important.

Ankylosing spondylitis labs 

The erythrocyte sedimentation rate (ESR)  is elevated in 85% of cases, but serologic tests for rheumatoid factor and cyclic citrullinated peptide (CCP) antibodies are negative. 

Anaemia may be present but is often mild. Such patients who have waist pain and ESRC, CCP raised the should do HLA-B27 test.

Ankylosing spondylitis radiology

Typically, the earliest radiographic changes occur in the sacroiliac joints.. In the first 2 years of the disease process, the sacroiliac changes may be detectable only by magnetic resonance imaging (MRI). 

Later, on simple radiographs, erosion and sclerosis of these joints are apparent; the sacroiliitis of ankylosing spondylitis is bilateral and symmetric.

Inflammation induces sclerosis ("the shiny corner sign") and then the characteristic squaring of the vertebral bodies when the annulus fibrosus initially binds to the vertebral bodies.

The word "bamboo spine" describes the spinal column's late radiographic appearance in which the vertebral bodies are fused by vertically oriented, bridging syndesmophytes produced by the ossification of the fibrous annulus and the degeneration of the spinal anterior and lateral tendons.

The fusion of the posterior facet joints of the spine is also common. Additional radiography include new periosteal bone development on the iliac crest, ischial tuberosities, and calcanei, and pubic symphysis and sternomanubrial joint modifications similar to sacroiliac ones. . 

Radiological changes in peripheral joints, when present, are asymmetric and lack the demineralization and erosions seen in rheumatoid arthritis.

Ankylosing spondylitis diet

Sun exposure is very important in ankylosing spondylitis between 8 am to 8: 30 am, because of this, it can greatly reduce the pain. Similarly, making some dietary changes can reduce the severity of ankylosing spondylitis. 

The following are the best diets for patients with ankylosing spondylitis,

• Green leafy vegetable  

• Fresh fruit

• Dry fruit

• Olive extra virgin 

• Seafood 

Ankylosing spondylitis treatments

Nonsteroidal anti-inflammatory drugs (NSAIDs) remain the first-line treatment of ankylosing spondylitis and may slow radiographic progression of spinal disease.
 

Because individual patients differ in their response to particular NSAIDs, empiric trials of several NSAIDs are warranted if the response to any given NSAID is not satisfactory. 

TNF inhibitors have developed efficacy for an axial disease resistant to NSAID; responses are often significant and long-lasting.

Etanercept (50 mg subcutaneously once a week), adalimumab (40 mg subcutaneously every other week), infliximab (5 mg/kg intravenously every other month), or golimumab (50 mg subcutaneously once a month) Patients whose symptoms are refractory to NSAIDs are rational.

Sulfasalazine is often helpful for peripheral arthritis (1000 mg orally twice daily) but lacks efficacy for spinal and sacroiliac joint disease.

Corticosteroids have minimal impact on arthritis -particularly the spondylitis-of ankylosing spondylitis and can worsen osteopenia. For guidance in postural exercises, all patients should be referred to a physical therapist.