Ankylosing Spondylitis

What is Ankylosing Spondylitis?

Ankylosing Spondylitis is a progressive form of arthritis that targets the spine and sacroiliac joints. Over time, the condition may cause stiffening of the spine and eventually the bones in the spine (vertebrae), may fuse together. Because of this, as the disease progresses, many people develop bent posture. AS affects 129 out of every 100,000 people in the US and although the average patient is a male, ages 15-30, women are affected as well. Many researchers believe men are more likely to develop the disease than women, while others argue that the incidence in men and women is equal.

Symptoms and Causes

The cause of AS is unknown, but recent studies suggest genetic links or certain bacteria as the culprit. There is no concrete evidence that bacteria causes AS.

Depending on the severity of the condition, the following symptoms may be present:

  • Difficulty bending the spine
  • Bent-over posture
  • Weight loss
  • Loss of appetite
  • Fatigue, fever
  • Pain in the feet (generally in the heels and soles)
  • Sensitivity to light
  • Back pain
  • Bowel Inflammation
  • Difficulty taking deep breaths
  • Difficulty walking, pain in the hips
  • Eye pain, swelling and redness
  • Heart block or failure
  • Stiffness or pain in the hips, back and buttocks in the morning or after a period of inactivity like sitting.

Treatments and side effects

Given the advances in treatments, Kyphosis (forward curvature of the spine, bent posture) is far less common today than it was yesterday. Physical therapy, regular exercise (swimming, jogging), deep breathing, stretching (yoga, pilates), a starch free diet and good posture can help manage the condition. If needed, there are several types of medications that are used to treat AS including:

  • NSAIDS: aspirin, ibuprofen, naproxen and COX-2 inhibitors which help to reduce pain and inflammation. Major side effects are few and occur infrequently. If they do occur, side effects may include nausea, vomiting, diarrhea, abdominal pain, anemia, and blood or protein in the urine.
  • DMARDs: Short for disease-modifying antirheumatic drugs. These drugs act by altering the immune system function to halt the underlying processes that cause certain forms of inflammatory arthritis. Not only do these drugs treat the symptoms, but they can also slow down progressive joint destruction. Side effects depend on the type of DMARD. Some have little or no side effects while others can possibly cause baldness, rash, diarrhea, liver and kidney problems.
  • Steroids: Used during flare-ups, may be injected directly into the joints, if misused side effects can range from baldness and acne to liver and kidney problems, rage, heart disease, impotence, and high blood pressure.
  • Biologics: Administered through injection or intravenously, the medication affects a specific component of the immune system (cytokines), which play an important role in fueling or suppressing inflammation. Biologics can inhibit or supplement cytokines and they have fewer side effects than some AS medications. Biologics suppress the immune system which may make the body more prone to infections and diseases.

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