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Ankylosing spondylitis is an autoimmune disorder that is typically characterized by inflammation in joints between the vertebrae of the spine or of the vertebrae located between the spine and pelvic region. Although prevention of this disorder is not possible, knowing the signs and symptoms and your risk factors can aid in diagnosis, which can lead to earlier treatment and slow the progression. However, it is important to mention that remission is usually only short lived and individual experiences will vary by the patient.

Risk Factors for Ankylosing Spondylitis

The risk factors for developing it include heredity, age and sex. Men are more likely than women to suffer from this disorder and those with a family history are also more likely to suffer from it. In most cases, the initial signs and symptoms appear between the late teens and the age of 40. However, there have been incidents of younger or older persons that exhibit signs and symptoms at an earlier or later point in life.

What Are the Signs and Symptoms of AS?

There are multiple signs and symptoms. While the chief complaint for many patients is back pain and inflammation, other areas of the body may be affected. In the early stages, symptoms may only be limited to pain in the hips and back, but as the disease progresses more subtle changes can be noted. This can include problems with the eyes, pain and inflammation of joints and tendons in other areas of the body, such as the torso, legs and lower extremities. In the more advanced stages can cause more serious and systemic effects. This can include sensitivity to light, blurred vision, decreased mobility and weight loss. In some cases, bowel inflammation and stooped posture can also occur.

Complications :

Serious complications can ensue. The disorder may be responsible for conditions such as anemia and inflammatory bowel disease. In addition to this, the heart and lungs can also be affected. Due to restrictions in chest expansion, breathing may become difficult for individuals in the latter stages. Heart valve disorders can also develop if the inflammation proceeds to the chest cavity. If the bones of the spine eventually fuse, mobility issues can become permanent.

Diagnosis:

There are many diagnostic considerations when it comes. In the early to middle stages of this disorder, the signs and symptoms may easily be attributed to other common conditions. Sprains, strains and arthritis may often be blamed. However, once the disease is suspected, the diagnostic process can begin. The physician will often order blood tests and/or x-rays to aid in confirming or denying a diagnosis of ankylosing spondylitis.

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Researchers recently announced that they have identified two genes responsible for causing ankylosing spondylitis. This disease causes back pain and progressive stiffness, and eventual fusing of the spine. Researchers believe that the same treatment currently being used to treat people suffering from Crohn’s disease may benefit people suffering from AS as well.

Scientists have believed that it was a genetic condition, but weren’t able to isolate the genes believed to be involved in creation of this disease. Now, researchers have identified two genes that appear to contribute to the occurrence. Participation in the human genome program has helped lead researchers to their findings.

“It is a painful and often very disabling disease. Yet, our understanding of the causes of the disease, and hence our ability to treat it effectively, is relatively poor,” said Matthew Brown, a professor from the Wellcome Trust Centre for Human Genetics at the University of Oxford.

Before this study, scientists already knew that it was common to see people with AS have other autoimmune diseases, such as psoriasis or Crohn’s disease. This research has shown that these diseases are genetically linked.

Knowing that these diseases are genetically linked has opened the door for research into treating disease. One of the treatments under investigation for Crohn’s disease involves inhibiting the ability for a particular gene to become inflamed. Armed with this new knowledge, researchers will also look for ways that this research can help people suffering from it.

Researchers studied the DNA of over 1,000 different patients who had this disease. They also studied the DNA of over 1,500 people who did not have this disease. They wanted to see if genetics could have played a role in the development of this disease. Not only did they discover genetic differences, but their results also were verified by a different team of researchers at the University of Texas (Houston).

It is a form of degenerative inflammatory arthritis that typically affects the spine and joints. The spines of people who suffer from it will eventually find that their spine has fused together.

It affects up to 1 in 500 women and 1 in 200 men in the United Kingdom. This disease usually strikes people in their twenties, or late teens.

Famous people who have suffered with AS include Ed Sullivan – the Ed Sullivan Television Show, Mick Mars – guitarist with Motley Crue, Lee Hurst – British comedian, Rico Brogna – former U.S. Major League baseball player, and Mike Atherton – former England cricket captain.

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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. Ankylosing Spondylitis 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 in 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, 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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There are many different types of arthritis – generally defined as inflammation of joints due to metabolic or infectious causes. The most common type is osteoarthritis, which occurs mainly in people over 40. The second most common type, which occurs more often in women than in men and may strike at any age, is rheumatoid arthritis. This type is also considered potentially the most serious of all the various types of arthritis. Another type of arthritis – juvenile chronic arthritis – affects children below the age of 16.

One type of arthritis, which is said to be the third most common type of arthritis in some countries, occurs mostly in young men in the late teens to early thirties age bracket. This type of arthritis is called ankylosing spondylitis. Considered an inflammatory disorder of the spine, ankylosing spondylitis can often be overlooked. A young man’s susceptibility to ankylosing spondylitis may be hereditary, much like that in the case of rheumatoid arthritis. The only difference is that a young man suffering from ankylosing spondylitis is seronegative, that is, he does not carry the rheumatoid factor in his blood. One of the possible triggers of this spinal disease is bowel infection.

The onset of ankylosing spondylitis is marked with inflammation of the connective tissues that bind the vertebrae together; the inflammation causes diminution in spinal mobility. In some cases of this type of arthritis, the joints in the arms and legs may be affected. The inflamed connective tissues may cause the spine to become permanently stiff as a result of their having calcified or hardened. In greatly-developed cases of ankylosing spondylitis, such as those in which treatment has been delayed, the entire spine may become fixed in a characteristic forward-and-downward bent position.

Solicitous lifelong supervision is required in all cases of ankylosing spondylitis. This is necessary in order that flexibility is maintained and structural deformity minimized. The chief medications for this type of arthritis are the nonsteroidal anti-inflammatory drugs, or NSAIDs. Over-the-counter NSAIDs include ibuprofen (example, Advil) and acetylsalicylic acid (example, Anacin), while prescription NSAIDs include naproxen sodium (example, Aleve) and ketoprofen (example, Oruvail).

To stretch the spine as well as the muscles supporting it and to better overall posture, physiotherapy can help a great deal. In severe cases of ankylosing spondylitis, the doctor may, if necessary, prescribe more powerful medications (such as steroids) that require his careful monitoring; he may also recommend radiotherapy to treat the condition.

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