Definition
Ankylosing spondylitis is a greatly debilitating rheumatic disease, the target of which is the spine and the skeletal muscle 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 inserted between the spondyloarthritis and, after rheumatoid arthritis, represents the most frequent and most serious degenerative disease.
Ankylosing spondylitis is a subtle disease: in the initial stage, the pain only affects the spine, and then hits the lower extremities, knees and shoulders. In the most serious cases, the disease could cause total disability to the patient.
Analysis of the term
Incidence
Ankylosing spondylitis is a predominantly male disease: estimates show that the incidence of the disease is 3 times greater in "strong sex" than in women. Generally, ankylosing spondylitis affects children after age 10 and adult subjects between the ages of 20 and 40; however, there is a late form that affects the fifty and sixty years old.
Generally, 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 90% of Caucasian patients the presence of the HLA-B27 gene was found, while it appears that in black subjects suffering from spondylitis the HLA-B7 gene is the most responsible. Furthermore, the statistics report staggering data: it seems that 20% of healthy people with HLA-B27 are strongly at 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, this does not mean that some environmental factors can play a relevant role in its debut.
Symptoms
To learn more: Ankylosing Spondylitis Symptoms
Inflammation in the joints 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 initial stages, spondylitis could be mistaken for a simple back pain (low back pain), easily reversible with sport and rest: in this phase, generally, albeit annoying, the pain is not acute. Because of this "slight" initial back pain and the "presumed" reversibility of pain, ankylosing spondylitis is often diagnosed late, when it is too late.
With the inexorable evolution of the disease, lower back pain becomes more acute and more extensive; the damage extends to several points in the spine, bringing back structural changes in the spine. The sick patient is not able to move properly, he is unable to flex, nor to twist, let alone extend. In the case of ankylosing spondylitis, common movements are denied: the simple act 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 has a lateral gaze, with an inability to flex and twist the neck.
In very severe cases, the disease causes respiratory defects: some unique cases of respiratory failure (rare pathological event) caused by ankylosing spondylitis have been reported.
In other patients with ankylosing spondylitis, other diseases have been diagnosed: Crohn's disease, acute iritis, anterior uveitis, ulcerative colitis sometimes associated with low-grade fever and anemia. The concomitant cardiovascular pathologies are rare.
Diagnosis and therapies
See also: Drugs for the treatment of ankylosing spondylitis
The investigation of the joints affected by the disease, the intensity of pain and the search for the HLA-B27 gene represent the three most used diagnostic measures. Furthermore, 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 pathology, 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 failure to intervene promptly makes the patient's recovery very difficult. In this regard, it is advisable to visit the doctor from the first back pain, apparently harmless: the "simple" low back pain in question should never be underestimated, nor understood as a simple and transitory benign form, since it could be a spy of diseases well more serious.
When ankylosing spondylitis is diagnosed early, the doctor should recommend physical exercise and some targeted physiotherapy massages, in conjunction with the use of NSAIDs (Non-Steroidal Anti-Inflammatory Drugs). For the most common pathological forms, antirheumatic drugs or corticosteroids are usually prescribed.
Ankylosing spondylitis and diet
Some authors venture an innovative approach to redeem joint inflammation: it seems that a diet rich in omega 3 can, in some way, modulate the phlogistic manifestation of spondylitis. Recent studies have shown that omega 3 can reduce and reduce inflammation, pain and postural stiffness: obviously, the "enriched" diet of omega 3 cannot replace pharmacological treatment, but could be a valid aid for the reduction of related symptoms.
However, it is worth remembering that a valid nutritional approach is useful to the patient (also and above all) to live with ankylosing spondylitis, without ever neglecting the pharmacological intake.
Summary
To fix the concepts
Disease | Ankylosing spondylitis |
Description | Ankylosing spondylitis is a systemic, chronic and autoimmune disease, a remarkably debilitating rheumatic disease whose target is a spine and a skeletal muscle system |
| Etymology of the term | "Spondylite" comes from the Greek spondylos (literally, "vertebra"), the suffix -ite indicates inflammation at the level of the vertebrae |
| Incidence of spondylitis | Predominantly male disease (incidence 3 times higher in men than women): 10-year-old children, men between 20 and 40 years old |
| Late form of ankylosing spondylitis | It affects fifty and sixty year olds |
| Causal factors | Ankylosing spondylitis is a genetic disorder. Multiple genes are involved:
Two other genes implicated in the disease: ARTS1 and IL23R |
| Symptomatology of ankylosing spondylitis |
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| Diagnose ankylosing spondylitis |
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| Therapies to improve / cure spondylitis | Sports, exercise, targeted physiotherapy massages, NSAIDs, antirheumatic drugs, corticosteroids, diet rich in omega 3 |
