Definition
Ankylosing spondylitis is a remarkably disabling rheumatic disease, whose target is the vertebral column and the musculoskeletal system in general: spondylitis is a systemic, chronic and autoimmune disease which, in the most serious cases, causes a real fusion of the joints .
Ankylosing spondylitis is part of the spondyloarthritis and, after rheumatoid arthritis, is the most frequent and most serious degenerative disease.
Ankylosing spondylitis is a subtle disease: in the initial stage, the pain affects only the spine, and then affects the lower extremities, knees and shoulders. In severe cases, the pathology could cause total disability to the patient.
Term analysis
Incidence
Ankylosing spondylitis is a predominantly male disease: estimates record, in fact, an "incidence of the disease 3 times greater in the" stronger sex "than in women. Generally, ankylosing spondylitis affects children after 10 years of age and adult subjects. between 20 and 40 years; however, there is a late form that affects the fifties and sixties.
In general, female ankylosing spondylitis has a less severe course than that of the male counterpart.
Causes
Ankylosing spondylitis is a genetic disorder, therefore some genes responsible for the pathological manifestation have been identified: in particular, the presence of the HLA-B27 gene and the HLA-B7 gene has been found. Furthermore, the statistics report staggering data: it appears that 20% of healthy people with HLA-B27 are at high risk of ankylosing spondylitis.
Only recently, two other genes implicated in the disease have been discovered: ARTS1 and IL23R.
As we have seen, genetic predisposition is an absolutely indispensable factor for the manifestation of spondylitis: in any case, the fact remains that some environmental factors may play a relevant role in its onset.
Symptoms
For further information: Symptoms Ankylosing Spondylitis
Inflammation in the joint is caused by an "infiltration of macrophages and elements of the immune system at the level of the cartilage: when the inflammation is not treated promptly, these substances are responsible for the" bone block ", mainly due to scarring and subsequent joint stiffening.
In the early stages, spondylitis could be mistaken for simple back pain (low back pain), easily reversible with sport and rest: in this phase, generally, although annoying, the pain is not acute. Precisely because of this initial "slight" back pain and the "presumed" reversibility of the pain, ankylosing spondylitis is often diagnosed late, when it is too late.
With the inexorable evolution of the disease, the lumbar pain becomes more acute and more extensive; the damage extends to several points of the spine, causing structural changes to the spine. The sick patient is unable to move correctly, unable to flex , neither to twist nor to extend.In the case of ankylosing spondylitis, the common movements are denied: the simple gesture of picking up an object that has fallen to the ground is an almost impossible attempt.
In the "pathological evolution of spondylitis, there is also an evident cervical involvement in the affected patient: the subject presents a glance lateral, with inability to flex and twist the neck.
In very severe cases, the disease causes respiratory defects: some singular cases of respiratory failure (a rare pathological event) caused by ankylosing spondylitis have been recorded.
Other diseases have been diagnosed in other patients with ankylosing spondylitis: Crohn's disease, acute iritis, anterior uveitis, ulcerative colitis sometimes associated with low-grade fever and anemia. Concomitant cardiovascular diseases are rare.
Diagnosis and therapies
See also: Drugs to Treat Ankylosing Spondylitis
The investigation of the joints affected by the disease, the intensity of pain and the search for the HLA-B27 gene are the three most used diagnostic measures. In addition, in an affected patient, other factors must also be taken into account: posture of the subject and degree of bone calcification.
In the most advanced stage of the disease, the damage is irreversible and there is no therapy that guarantees improvement. The most serious problem, as already mentioned, is represented by the late diagnosis, since the lack of timely intervention makes the patient's recovery very difficult. In this regard, a medical examination is advisable from the first apparently harmless back pain: the "simple" low back pain in question should never be underestimated, nor should it be understood as a simple and transient benign form, as it could be a sign of well-known diseases. more serious.
When ankylosing spondylitis is diagnosed early, the doctor should recommend physical exercise and some targeted physiotherapy massages, in conjunction with the intake of NSAIDs (Non-Steroidal Anti-Inflammatory Drugs). For the major pathological forms, antirheumatic drugs or corticosteroids are usually prescribed.
Ankylosing spondylitis and diet
Some authors venture an innovative approach aimed at redeeming joint inflammation: it seems that a diet rich in omega 3 can, in some way, modulate the inflammatory manifestation of spondylitis. Recent studies have shown how omega 3 can reduce inflammation, pain and postural rigidity: obviously, the diet "enriched" with omega 3 cannot replace the pharmacological treatment, but it could be a valid help for the reduction of related symptoms.
In any case, it is good to remember how a valid nutritional approach is useful to the patient (also and above all) for cohabit with ankylosing spondylitis, without ever neglecting the drug intake.
Summary
To fix the concepts
Illness
Ankylosing spondylitis
Description
Ankylosing spondylitis is a systemic, chronic and autoimmune disease, a greatly disabling rheumatic disease whose target is represented by the vertebral column and the musculoskeletal system.
"Spondylite" comes from the Greek spondylos (literally, "vertebra"), the suffix –ite indicates "inflammation in the vertebrae
Predominantly male disease (3 times higher incidence in men than in women): 10-year-old children, 20-40-year-old men
It affects people in their fifties and sixties
Ankylosing spondylitis is a genetic disorder. More genes are involved:
- HLA-B27 gene
- HLA-B7 gene
Two other genes implicated in the disease: ARTS1 and IL23R
- "bone block" due to scarring and joint stiffening
- mild and reversible low back pain (early stage)
- sharper and more extensive lower back pain (disease progression)
- extension of the damage in several points of the spine
- structural modifications of the spine
- inability to move (twisting, flexing, stretching)
- cervical involvement
- breathing defects (respiratory failure)
- Crohn's disease, acute iritis, anterior uveitis, ulcerative colitis sometimes associated with low-grade fever and anemia
- Investigation of the joints affected by the disease
- Assessment of pain intensity
- Search for the HLA-B27 gene
- Analysis of the subject's posture and the degree of bone calcification
Sport, exercise, targeted physiotherapy massages, NSAIDs, antirheumatic drugs, corticosteroids, diet rich in omega 3
