Ankylosing Spondylitis treatment, diet, food, supplements and danger of using certain prescription medications, symptom relief with natural remedy
May 16 2016 by
Ray Sahelian, M.D.

Ankylosing spondylitis is an inflammatory chronic disease that affects young males and in more than 90% of cases is associated with HLA B27 antigen. Therapeutic options for patients with this condition has been limited.

Diet and food
It is possible that diet and certain supplements could be helpful in reducing symptoms of ankylosing spondylitis. Consuming an anti-inflammatory diet mostly made composed of vegetables and fish could be helpful.

Natural therapy for ankylosing spondylitis and supplements
Perhaps fish oil supplements, 5 to 10 pills a day, could ease symptoms of this condition. You could also consider other therapeutic remedies listed in the joint pain article.

Supplementation of omega-3 fatty acids in patients with ankylosing spondylitis.
Scand J Rheumatol. 2006. Sundstrom B. Department of Medical Rehabilitation, Gallivare Hospital.
To study the effect of supplementation with omega-3 fatty acids on disease variables and drug consumption in patients with ankylosing spondylitis. Twenty-four patients were randomized to either a low-dose (2 g omega-3/day) or a high-dose (4.5 g omega-3/day) supplement. Disease activity, functional impairment, erythrocyte sedimentation rate (ESR), and drug consumption were assessed during visits at baseline and at weeks 7, 14, and 21.Results: Eighteen patients completed the study, nine patients from each group. The patients in the high-dose group exhibited a significant decrease in disease activity according to the Bath Ankylosing Disease Activity Index, which was not seen in the low-dose group. Significant differences were not found on drug consumption or in functional capacity in either of the groups. No significant differences were found when comparing the results between the high- and low-dose groups. Omega-3 fatty acids in adequate doses may have the capacity to decrease the disease activity. However, larger and better controlled studies are needed before any further conclusions can be made on the extent of this capacity.

I am a medical doctor and have a question in relation to the condition ankylosing spondylitis, would you know of any herbal or Ayurvedic remedy for this condition. If you ever travel to south Asia (Sri Lanka and/or India) I would very much like to meet with you. You are always welcome here in Colombo, Sri Lanka which a long history of herbal medicine.
   Thank you for the invitation. It appears anti-inflammatory approach is a good option and we will update this page as more info is published. Fish oils and eating more fish and vegetables should be tried.

Medical therapy update
Curr Allergy Asthma Rep. 2015 Jan. Update on ankylosing spondylitis: current concepts in pathogenesis. Genome-wide association studies of this highly genetic disease have implicated specific immune pathways, including the interleukin (IL)-17/IL-23 pathway, control of nuclear factor kappa B (NF-κB) activation, amino acid trimming for major histocompatibility complex (MHC) antigen presentation, and other genes controlling CD8 and CD4 T cell subsets. The relevance of these pathways has borne out in animal and human subject studies, in particular, the response to novel therapeutic agents. Genetics and the findings of autoantibodies in ankylosing spondylitis revisit the question of autoimmune vs. autoinflammatory etiology. As environmental partners to genetics, recent attention has focused on the roles of microbiota and biomechanical stress in initiating and perpetuating inflammation.

Radiographic progression occurs at similar rates in the spines of ankylosing spondylitis patients treated over 2 years with either continuous or on-demand diclofenac.

Ankylosing spondylitis medication
Non steroidal antiinflammatory drugs (NSAID) used to be the only drugs active in this condition. However, they are inadequate or ill-tolerated in many patients, and have no proven impact on disease-related structural changes. Clinical trials have shown two anti-TNF alpha agents - infliximab and etanercept - could be helpful in patients with NSAID-resistant ankylosing spondylitis. These drugs ease inflammatory pain, stiffness and functional disability, and improve mobility and quality of life. Tolerability is satisfactory, and efficacy persists during several years of treatment. There is not enough evidence to support any benefit of methotrexate in the treatment of ankylosing spondylitis.

The management of ankylosing spondylitis and other spondyloarthritides such as psoriatic arthritis is becoming more and more complex due to major advances, especially in the pharmacological therapy of these diseases. Biologics such as the anti-tumour necrosis factor agents have the potential to improve outcome parameters usually assessed.

Infliximab for ankylosing spondylitis
Treatment with Infliximab in a patient with ankylosing spondylitis and Crohn's disease.
J Gastrointestin Liver Dis. 2006. Department of Rheumatology, "Iuliu Hatieganu" University of Medicine and Pharmacy Cluj-Napoca, Romania;
The association of Crohn's disease and ankylosing spondylitis is described in up to 30% of cases. We present the case of a 53 year old woman, diagnosed with colonic Crohn's disease and ankylosing spondilitis, treated initially with increasing doses of sulphasalazine and moderate dose of corticosteroids, with the persistence of severe gastrointestinal and articular symptoms. She underwent therapy with tumor necrosis factor alpha (TNFalpha) inhibitor Infliximab, with a spectacular improvement of symptoms, signs and quality of life.

Caution and danger: Infliximab is a chimeric monoclonal antibody against TNF-alpha useful in the treatment of many chronic inflammatory diseases. Severe anaphylaxis has been reported during therapy. In some patients with infliximab related severe reactions, IgE or IgM antibodies against infliximab are detectable. The majority of reactions can be predicted by the appearance of anti-infliximab antibodies.

Etanercept for ankylosing spondylitis - side effect
Adverse effect of TNF-alpha blocker etanercept - Demyelination in an ankylosing spondylitis patient: a case report.
J Clin Pharm Ther. 2006.
Anti-tumour necrosis factor (TNF)-alpha agents promise better disease control for treatment of inflammatory arthritides which are resistant to classical disease-modifying treatment and provide better functional outcome. But these agents are not free of adverse events. The exact relationship between use of anti-TNF drugs and development of demyelination cannot be established yet. Here we present a case of a 36-year-old man who developed demyelination in the cervical spinal cord while he was being treated with etanercept for ankylosing spondylitis.

Turk J Med Sci. 2014. Anti TNF-α therapy might be responsible for an increased incidence of varicocele in patients with ankylosing spondylitis.

Tooth and gum disease
Ankylosing spondylitis increases the risk of periodontal disease. Dr. Nicole Pischon at Charite-Universitats medizin Berlin reports that both diseases are characterized by dysregulation of the host inflammatory response, resulting in soft and hard connective tissue destruction. Dr. Nicole Pischon indicates that is an increased risk of periodontal attachment loss among patients with inflammatory rheumatic diseases. Annals Rheumatic Diseases 2010.

Genetics is the main cause. Some claim that Klebsiella pneumoniae is a microbial agent being implicated as a triggering and/or perpetuating factors.