Talk:Ankylosing spondylitis/Archive 2

Archive 1

Archive 2

How to mention Carol Sinclair book without it sounding like an advertisement?

A lot of people with AS (like me) have benefited greatly from the low-starch diet. The best source that I know of on this is "The IBS Low-Starch Diet" by Carol Sinclair. I've noticed that earlier versions of the article mentioned the book, but it was reverted. This is a book that would be extremely helpful to a lot of people if it could be mentioned in the article, so my question is, how can that book be mentioned in a way that would be acceptable? 71.214.60.189 (talk) 19:46, 12 January 2010 (UTC)

This is easy. We are not a self-help or advice column, but an encyclopedia. We are interested in only the high-level medical effects of AS. We are not trying to help anybody unless they can profit from researched information. This makes it easy to decide what goes here and what doesn't. A popular book would not. Try a blog or a .com site. Thanks for checking first! Student7 (talk) 23:56, 14 January 2010 (UTC)

Differential Diagnosis from Post-Polio Problems?

I wish to ask a qualified medical expert to add material on the Differential Diagnosis between AS and after-effects of a defeated polio infection. In the late 1980s the then-top-ranking specialist in A.S. at a hospital on Manhattan's East side, either The Hospital For Special Surgery or The Hospital For Joint Diseases (I can't remember which), told me that any alleged FATAL case of A.S. MUST be a misdiagnosis of progressive effects from a defeated polio infection. He stated this confidently as fact, having no possibility of having acquired independent confirmation that indeed the case to which I was referring involved a polio infection long preceding the A.S. diagnosis, and was accompanied by intestinal problems in line with what I have since read elsewhere about post-polio syndromes. All children of the decedent are aged above 48 with no signs of A.S. among them.69.86.126.190 (talk) 03:15, 30 June 2010 (UTC)Christopher L. Simpson

Fibromyalgia Confused with AS?

I'm wondering if "Fibromyaligia" is being confused in some people with AS.. and if there is any research out there.. especially in light of the fact that AS may be underdiagnosed in Women, and women tend to suffer more often from "Fibromyalgia"

• I agree. Related disease? Spondyloarthropathy--User:Warrior777 (talk) 07:41, 23 November 2011 (UTC)

Also I am male, aged 31, and wikipedia and the no starch diet saved my life, more or less, after a 2-3 month battle with severe back pain I had two years ago. I don't seem to need to maintain strict NSD all the time, but I watch it and sometimes have to be more strict. I have been relatively pain free for two years with reduced starch diet, swimming, stretching etc, whereas I used to get major episodes of pain once or twice a year from my teens to late 20s. —Preceding unsigned comment added by 75.72.202.72 (talk) 21:49, 15 July 2010 (UTC)

Autoimmune Disease?

The main article states ankylosing spondylitis is an autoimmune disease. If it is, this needs a citation. The following articles do not call it an autoimmune disease:

• Arthritis.org, Ankylosing Spondylitis, What is it? http://www.arthritis.org/disease-center.php?disease_id=2
• Spondylitis Association of America, Ankylosing Spondylitis, Overview http://www.spondylitis.org/about/as.aspx
• MedlinePlus, Medical Encyclopedia, Ankylosing Spondylitis http://www.nlm.nih.gov/medlineplus/ency/article/000420.htm

--EricE (talk) 20:36, 23 August 2010 (UTC)

You may be right about needing a citstion, but I believe all 100 or so forms of arthritis are essentially auto-immune diseases. Kind of a basis for the genre, as it were. Student7 (talk) 21:05, 25 August 2010 (UTC)

I still think so, but not quite as sure as I was when I wrote the above!  :) Student7 (talk) 21:14, 25 August 2010 (UTC)

Merck Manual also does not call it autoimmune. Since Merck, Arthritis Foundation, and MedlinePlus all explicitly declare rheumatoid arthritis autoimmune, I lean to believing AS should not be called autoimmune. My understanding is that cause of AS is too poorly understood to confidently say it "is an autoimmune disease." The way Merck puts it "The pathophysiology probably involves immune-mediated inflammation." That seems more appropriate than it "is autoimmune." --EricE (talk) 01:58, 27 August 2010 (UTC)

Here's a reliable source: http://www.nlm.nih.gov/medlineplus/ankylosingspondylitis.html Hanxu9 (talk) 00:24, 5 November 2010 (UTC)

Thanks. I've inserted it. Student7 (talk) 15:07, 6 November 2010 (UTC)

AS is not autoimmune but in fact auto-inflammatory that is why all sources except medlineplus, which is incorrect, do not claim an autoimmune connection. Http://www.spondylitis.org/about/as.aspx will have the most up to date content since they are primarily focused on spondylitis research and awareness. (UTC) Taberge (talk) 04:30, 22 May 2011 (UTC)

Could it be a growth disorder of unknown origin with inflammatory symptoms? Perhaps the disease is not a dysfunction at all but an abnormality in normal growth (growth continuance, post maturation) effecting neighboring tissues in an inflammatory way.--User:Warrior777 (talk) 07:58, 23 November 2011 (UTC)

Please confine discussion to article improvement (i.e. existing knowledge). Thanks. Student7 (talk) 15:14, 26 November 2011 (UTC)

Pathophysiology

The Pathophysiology section in the context of Klebsiella must be cleaned up. The journal articles involved are poorly referenced and explained. This section is misrepresenting of the major research done.

I found the last line of the current section poor:

"Toivanen (1999) found no support for the role of Klebsiella in the etiology of primary AS.[9]"

As a summation of this Toivanen article on Klebsiella published in the Journal of Clinical Microbiology, this brief statement, which is meant to represent a complex study, is very vague and in my consequently misleading.

And I quote, "The purpose of the present study was to find out whether patients with ankylosing spondylitis (AS) carry fecal Klebsiella strains that belong to serotypes or species specific for AS"

The findings of the study included no significant trend of a major Klebsiella strain for those diagnosed with A.S.

Although the abstract finishes "These findings do not indicate participation of Klebsiella in the etiopathogenesis of AS.", the findings were not aimed at etiology!!!

Understand that this was not a study of etiology, but rather a study of whether groups of people were carrying a specific strain post-development and post-diagnosis.

Read on, "Finally, even though the present results did not reveal any difference between AS patients and the controls, they do not totally exclude the potential role of Klebsiella in the etiopathogenesis of AS. This conclusion is based on the findings of studies of reactive arthritis following enteric infections caused by Campylobacter, Salmonella, Shigella, or Yersinia (24). At the time of development of arthritis, the diarrhea-causing bacterial triggers are only rarely culturable from stool samples, even though traces of them may be found within the joint tissue; diagnosis of the disease is mostly based on the patient's history and antibody responses (8, 23). Parallel to this, a possibility exists that an initial process (e.g., enteric colonization) that leads to development of AS occurs and subsides before AS becomes manifest. In such a case, the specific bacterial trigger might already be absent from the feces at the time of fully developed disease. Nevertheless, we must conclude that the results of the present study do not indicate involvement of Klebsiella in the etiopathogenesis of AS. This is based both on the rates of carriage of Klebsiella as well as the prevalence of serotypes, including O groups and K serotypes, and the distribution of Klebsiella species in AS patients and the controls. "

Decks7507 (talk) 15:37, 31 December 2010 (UTC)

• Comment I agree, as presented it appears as original research (WP:NOR) and POV (WP:POV). This may cause trouble for the article and should be removed unless clearly stated verifiable (WP:VERIFY) primary, secondary, and tertiary sources (WP: PSTS) of citation can be provided, even then it may not be notable (WP:NOTE), yet.--User:Warrior777 (talk) 05:32, 21 July 2011 (UTC)

Categories added and corrected

I've added two categories to the article

• Rhuematology
• Skeletal disorders
• and corrected the lower case misspelling of category so that the Ankylosing Spondylitis would appear as a category.

--User:Warrior777 (talk) 19:19, 20 July 2011 (UTC)

Added category

• Spondyloarthropathy but the link is not functioning

--User:Warrior777 (talk) 07:28, 21 July 2011 (UTC)

One in a 1,000,000

AS is a rare disease, if not rare, a very uncommon disease effecting only one out of every one million people. It is possible many with borderline cases maybe going untreated due to the difficulties in diagnosis of the disease. This point should be included in the text. Perhaps some reference should be made to "orphan diseases[1]" and the lack of research funding for them.--User:Warrior777 (talk) 08:18, 21 July 2011 (UTC)

Regarding this

"Factors that may affect recovery."

Rheumatologists are aware that once spinal fusion is complete pain diminishes though the risk of fractures increases and might be added to the article should suitable reference sources be found. (The fusion process may take years to decades to complete.) This information might be important to numerous readers of the article and their families.--User:Warrior777 (talk) 07:08, 23 November 2011 (UTC)

For the record, the encyclopedia is for researchers. It is not a self-help manual, nor a repository of the newest information, which is often not yet accepted by all physicians. For up-to-date treatment, readers should consult their physicians or a medical reference. Student7 (talk) 15:08, 26 November 2011 (UTC)

This information was provided by a physician, a rheumatologist. I have also heard of numerous other patients experiencing similar improvement after the fusion process stops. Neither hear-say nor testimonials are suitable for the wiki as I understand it so, references would be needed to confirm this testimonial. --User:Warrior777 (talk) 00:53, 29 November 2011 (UTC)

This is not the wiki article this is the discussion page concerning the article and yes, I am aware of your objections and there purposes. For the record.--User:Warrior777 (talk) 06:40, 30 November 2011 (UTC)

Jaw involvement (early onset of the disease/diagnosis)

Day time, temporomandibular joint disorder like symptoms involving the jaws (both sides) with visibly growing, bone spurs and growths within the mouth could be a valuable aid to detection and diagnosis of the disease and may also be an early indicator of disease onset. These symptoms occurring before Sacroiliac fusion and over-looked by Doctors and "Dentists". Research might be required before submission to the Wiki..--User:Warrior777 (talk) 07:31, 23 November 2011 (UTC)

About this

"Medical professionals and experts in AS have speculated that maintaining good posture can reduce the likelihood of a fused or curved spine which occurs in a significant percentage of diagnosed persons.[18]"

This part, "can reduce the likelihood of a fused"

At this time there is no cure for AS so the disease will continue. I have heard TNF drugs do help some suffers reduce fusion but they do have risks. I would remind you these drugs are still new to the treatment of AS. At one time during the history of AS braces were used to hold the back straight. Myself I think "soft braces" deserve a second look for night use and during activity for short durations of time while in a waking state. Additional research would be required to determine there effectiveness over the long term for adverse or positive effects.--User:Warrior777 (talk) 08:55, 23 November 2011 (UTC)

Additional comments

"often with pain referred to one or other buttock or the back of thigh from the sacroiliac joint." In addition, "the sacroiliac joins might ache during the fusion process leading to difficulty sitting." An ache, is a pain but it is different.

This is correct and was available in this form some years back. If you need a reference see brochures provided by the American Arthritis Association regarding AS where it still might be available. "Pain is often severe at rest, but improves with physical activity. However, many experience inflammation and pain to varying degrees regardless of rest and movement.[citation needed]"

Comment: Pain originates in the ligature and extends into the muscles. Pain that arises within the bone is largely due to the fusion process and bone spur growth. Most often the musculature pain is more acute then join pain, making AS similar to fibromyalgia in symptoms. Pain is perhaps most acute when the rib cage is involved which also effects sleep. Pain takes numerous forms over the duration of the disease. Pain also arises from stiffness, they can be one and the same, simultaneously.

This is correct but I do not have a reference for it: "which follows infections, the antigens involved are likely to be derived from intracellular microorganisms[citation needed]"

Other pathogens effecting AS: Some years ago there was some belief that this pathogen [[2]] was associated with the onset of AS though references were scant and may have been a research dead end.

Diagnosis: Ferguson's View (specialized sacroiliac view) is used to determine the presence of AS in the sacroiliac join. (standard x-ray views may miss the fusion.)

Diagnosis: Rheumatoid factor (SED rate) [[3]] are largely or completely absent in AS and its absence can aid physicians in ruling out RA as a cause.

Diagnosis: Crohn's disease like symptoms may appear with persons having Ankylosing Spondylitis or undifferentiated spondylotherapy. Complete endoscopy is needed before Crohn's disease may be ruled out as a cause.

Medication

NSAIDs can cause unexpected internal hemorrhaging and need to be administered and monitored by a physician. Two or more NSAIDS should not be used simultaneously. Read and follow label direction on all medications before using them.

Methotrexate, sulfasalazine require routine and frequent blood testing and monitoring to reduce possible adverse side effects.

Corticosteroids may cause delusion in patients. Corticosteroids are synthetic "fight/flight or rage" hormone from plant sources and may produce side effects similar to Anabolic steroid [4]. Base-line testing for naturally occurring hormone levels should be undertaken before dosages are determined. Corticosteroid usage should not be abruptly stopped.

Person with substance abuse histories should seek the advise of an addictionalogist [[5]]] before using pain medications.--User:Warrior777 (talk) 04:43, 30 November 2011 (UTC) — Preceding unsigned comment added by Warrior777 (talk • contribs) 04:36, 30 November 2011 (UTC)

If you have been recently diagnosed with AS I would like to say that there is one thing above all that you must cling to and that is hope. Grab hold of and cling to hope each and every day. Life is not suffering; it is a gift. Use this gift each and every days to its fullest. You may not get your life back as it was. You now have a new life with certain limitations. You will need to adapt and learn new ways to live within these limitations. Taking care of yourself will take on new meaning. You will need to learn when you can and when you can't. You will learn how to live a balanced life. Accepting this new life may come slowly, be patient with yourself and others. Remember always that you are not alone in your disease and all those with AS wish you all the best. My hope is and I'm sure everyone one with AS would agree, that our hope is that some day AS will be a thing of the past.

--User:Warrior777 (talk) 06:11, 30 November 2011 (UTC)

Disclaimer I am not a Doctor anywhere nor has the information I have provided and attempt to practice medicine in any way. The inputs I provided have been from my experiences with Ankylosing Spondylitis and may contain opinions and nonfactual information. --User:Warrior777 (talk) 06:29, 30 November 2011 (UTC)

Notable people with ankylosing spondylitis

I'm reading The Dirt and read that Mick Mars had ankylosing spondylitis, so I started a section for notable people with ankylosing spondylitis.[6] Articles on medical conditions often include lists of notable individuals who have (or had) the disease. See Wikipedia:MEDMOS#Notable cases. You might be able to expand the list via this search. -- JeffreyBillings (talk) 00:24, 19 December 2011 (UTC)

Well, the reason we got rid of this before was lack of accurate information on who had the disease. Anything short of an statement from a) the person and b) his doctor should probably not be acceptable. Cousins, probably the most notable person on the list, was mis-diagnosed by a family physician and probably had a reaction to particulates when he visited the USSR. He became "cured" which is impossible. Student7 (talk) 16:12, 23 December 2011 (UTC)

How do you _know_ it's _impossible_? Someone who is a "student" shouldn't use such strong language. Hanxu9 (talk) 23:36, 8 March 2012 (UTC)

This is just WRONG.

It doesn't start at age 10 =="AS typically begins in the second or third decade of the person's life and occurs more often in males."

You start your SECOND decade at age 10, and your THIRD decade at age 20. You probably meant to say "AS typically begins in your 20s or 30s" — Preceding unsigned comment added by 10:55, 21 June 2015 (talk • contribs) 73.170.79.95 (UTC)

Add my pic if you want

There's a part in this page where Arx Fortis has suggested getting a better picture, and a comment by Sensei on getting a picture showing the process of ankylosing. Most of the X-Ray or MRI pics don't make much sense to the ordinary person, except for one in the Diagnosis section which shows a bamboo spine. You can use my pics if you want; there are two pics, and the first one shows that the lower spine is fused but the upper vertebras are still free:

http://postimage.org/image/d87a9ocdp/

http://postimage.org/image/jboutl2nh/

I'm male, 30 years old. I had a disc injury L4-5 in 1999. Took bed rest for a month; the back pain and sciatica continued for at least two years, and even after that I had pain in the entire back, though it was much less. Fortunately I didn't need any injections or surgery. All these years, my back has been paining off and on, and if I sit for more than fifteen minutes, it gets stiff. The pain however is very less, I can easily ignore it. I think I had AS for quite some time but I kept attributing the pain to the disc injury. I don't remember much about how severe the pain was in all these years. This year I visited my doc again, and first he called it AS, but then changed it to Spondyloarthropathy after the HLA B-27 test came out negative. I've started Sulfasalazine once a day now, along with Naproxen twice. J.Bhargav (talk) 03:58, 5 March 2012 (UTC)

All pictures used in Wikipedia must come from (be legally released to) Wikimedia commons. We can't use "outside" and possibly copyright-implied photos. It is possible that these x-rays might be "owned" or partially so, by the technician/firm that took them.

Having said that, a sufferer myself, I find x-rays hard to understand. A drawing omitting "unnecessary" details (and released to Wikimedia! :) might be better. Thanks. Student7 (talk) 15:42, 9 March 2012 (UTC)

I know that this pic is mine; I've the hard copy as well. I'm not sure if the clinic where I got these pics taken have any rights over them. I doubt they even keep a copy of them. As for the X-Ray itself, I generally don't understand X-Rays myself, but I think mine is pretty clear: you can see the fusion on the lower vertebras, along with the formation of what they call Snydesmophytes. I'll edit out the unnecessary parts once I'm told I can upload the pic to Wikicommons. But this is if you people actually want to put it up on the main page. J.Bhargav (talk) 07:39, 11 March 2012 (UTC)

The other problem with Wikicommons is that we can't, in this day of photoshopping, "adjust" pictures. Credibility. My understanding is that the image must be untouched. Another reason for a good drawing, if one can be found. Hard to include "just" the ankylosing on an x-ray. Student7 (talk) 14:04, 12 March 2012 (UTC)

I'll leave the X-Ray image as it is then. There's not much point showing just the ankylosing without showing the non-ankylosed parts as well. And I'm not a doctor, so I don't understand the X-Ray fully myself, which is why I'd rather have a person with medical knowledge edit the page. But I need someone, an admin, to tell me whether or not they'll put this image on the page. Unless I receive confirmation, I won't upload the image to Wikicommons. J.Bhargav (talk) 02:27, 13 March 2012 (UTC)

Is Ankylosing spondylitis is still un-curable?

Is there any new finding in research? — Preceding unsigned comment added by 117.213.245.51 (talk) 18:20, 16 April 2012 (UTC)

Not a cure as such but there are two main alternative treatments that I know of which people are using. There really ought to be a section on alternative treatments, such as:

a) No starch diet (NSD) / Low starch diet - works well for some people. London Diet is another name for this diet. See: http://www.kickas.org/londondiet.shtml some info on the theory behind this is here: http://www.kickas.org/molecular_mimicry.shtml

b) Antibiotic protocols - such as the Marshall Protocol. See: http://marshallprotocol.com/ and http://mpkb.org/ and http://www.roadback.org/

There are some other more colourful ones.. such as in Russia I have heard of people sitting in a pool around a radioactive rock. Supposedly the radiation kills off the excess of white blood cells.

Besides these alternative therapies there are also Biologics which definitely need a mention on this page. These were initially quite dangerous (e.g.: side effects such as death and chronic infection) however they seem to be moving along quite well in improving the safety of these drugs. 129.78.233.211 (talk) 00:10, 26 April 2013 (UTC)

I would imagine antibiotics can kill the Klebsiella, and hence reduce the immune response. All the best: Rich Farmbrough, 19:45, 25 September 2014 (UTC).

The problem with lifestyle treatments for AS is that they ignore the fact that someone like me, with an advanced case of the disease plus a whole lot of complicating conditions, is not realistically able to carry them out. I cannot stand for more than a few seconds before muscle fatigue sets in and I start getting muscle spasms, dropping things, making mistakes related to lack of concentration because of the underlying pain, and so on. I would need to employ a full time home assistant in order to have my diet organized and prepared for me. Besides, I have tried multiple diets, when my symptoms were less severe, and nothing worked. Weight loss diets stopped working after a few months and I would start to gain weight in spite of stringent caloric restriction. (Some blame rests with long term prescription of Calcium Channel Blockers to control my BP. (Why do US doctors fail to even consider that their drug prescriptions may be harming their patients when the research literature indicates that they are unsafe for the elderly or those who have been on them for decades. Perhaps it is the insidious effect of quick and easy continuing-education solely at the hands of pharma-reps in the presence of an industry run be bean counters who insist that medical practitioners spend as little time as possible on individual patients so that they can maximize income - a the expense of the patients' well-being, of course.)

There are similar problems with exercise regimes. I would LOVE to be able to go walking on the many paths and tracks among the trees that are close to where I live. Instead, I have trouble just walking around the house and cannot even visit my next-door and across-the-road neighbor without difficulties. Physical Therapists just get frustrated with me and either blame me for failing to do the exercises (which is really cruel) or say that they wish they could find something to stop the resulting inflammation so that I could do the exercises their training told them would fix the problem by increasing my muscle strength. When the main problem now is painful muscle spasms why would I want my muscles to be even stronger so that they can spasm even harder? These health professionals simply cannot acknowledge that their treatments are harmful rather than beneficial by creating situations that further increase the underlying inflammation that is a hallmark of the disease. Furthermore, their blame-the-victim-rather-than-the-disease attitude decreases the positive mental attitude that is essential to coping as well as possible with the consequences of the disease. They get paid for berating me for things that I cannot do without serious consequences while I receive nothing for trying to fix the gaps in their professional knowledge. The training and continuing education of these professionals appears to be criminally lacking when it comes to conditions like this. — Preceding unsigned comment added by 2601:642:4100:4849:E56D:10C8:3CE9:DFC5 (talk) 17:46, 11 July 2018 (UTC)

Epidemiology needs rewrite

An editor tried to rewrite the section from Braun,Spieper. Ankylosing Spondylitis.Lancet 2007; 369: 1379–90 (http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2807%2960635-7/fulltext) by just copying the text. I agree that a rewrite is needed, and that this source would be an improvement, but it needs to be done without such copyright problems. --Ronz (talk) 16:12, 10 October 2012 (UTC)

Here's the book by the same authors: http://www.scribd.com/doc/50854946/5/Epidemiology-of-ankylosing-spondylitis --Ronz (talk) 16:18, 10 October 2012 (UTC)

Ankylosing spondylitis prevalence is between 0.1 and 0.2% of the general population.

But above we see 1.8...

Jidanni (talk) 22:58, 24 October 2017 (UTC)

Different sources say different things.[7] Doc James (talk · contribs · email) 02:03, 25 October 2017 (UTC)

Bechterew

The name of the disease shows divided usage but is commonly known as Bechterew's [[8]] after one of its discovers. While the rendition of his name may changed recently to a romanized form in some places, the widely used German form of the name of the disease has not, so this should be included. See for example the German Wikipedia[[9]]. I use a fixed ip. — Preceding unsigned comment added by 62.3.255.103 (talk) 21:47, 23 February 2013 (UTC)

Management

The article is very good- apart from one inaccuracy. The article states that opiate pain medication is addictive and rarely prescribed. It is commonly prescribed, even long term. If you wish to keep this information please cite it- as an AS sufferer, and one who knows of thousands of people with AS who ARE on narcotic pain meds, long term, this bit of the article is not accurate. 68.12.209.49 (talk) 16:49, 22 August 2013 (UTC)

My pain doctor prescribed heavy duty narcotic pain medication. I try not to take it if I can manage without it because I worry about addiction and permanent changes to pain response. This class of drug, however, the only thing that makes life bearable most of the time. I am 70 years old, and only recently diagnosed with what is now a severe case of AS. I don't have many more years of life and I would rather spend them in relative comfort. There is no longer any chance of total comfort. I am in some level of pain minute of every single day. — Preceding unsigned comment added by 2601:642:4100:4849:E56D:10C8:3CE9:DFC5 (talk) 17:14, 11 July 2018 (UTC)

DMARDs

This article says that DMARDs are used. The Lancet says that they're not effective for the axial symptoms. http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2813%2961134-4/abstract Anti-interleukin-17A monoclonal antibody secukinumab in treatment of ankylosing spondylitis: a randomised, double-blind, placebo-controlled trial Lancet, online first, September 13, 2013

Which is it? Does anybody have a good, recent source?

The Lancet also had some promising results with secukinumab, although it was only 30 patients. --Nbauman (talk) 00:26, 16 September 2013 (UTC)

Low starch

(See also a few sections up.) http://www.ncbi.nlm.nih.gov/pubmed/8835506 refers. Is there no further work on this? All the best: Rich Farmbrough, 19:46, 25 September 2014 (UTC).

I was diagnosed with AS in 2013, and have followed the London AS Diet (mentioned in the article, and proposed by Prof A. Ebringer) with great results; so little in the way of symptoms that it could almost be considered a cure (as long as you continue with the diet). I would like to have this more directly included in the "Treatment" section of the article, with appropriate caveats that this approach is based on a hypothesis that has not been proven (although there's plenty in the way of citations!) - however, as someone who actually HAS the disease, this could arguably be considered a conflict of interest and possibly not WIKIPEDAI:NPOV. Can I ask the thoughts of other editors on this page? if nobody feels desperately strongly, I'll have a go at creating some suitable language.FDCWint (talk) 17:09, 3 January 2015 (UTC)

Ankylos

Does it mean crooked? On the ankylosaur page it suggests fused. — Preceding unsigned comment added by 194.176.105.153 (talk) 09:01, 10 April 2015 (UTC)

Contradicted by literature review

I have moved this paragraph here for discussion:

The London AS Diet was developed by Professor Alan Ebringer at the Ankylosing Spondylitis Research Clinic, Kings College, London. It is a low starch diet.

Professor Ebringers' team found that Klebsiella bacteria in the colon to be a trigger in AS. The bacteria feed directly on starch, by reducing starch in diet Klebsiella are starved and numbers reduce. This is benificial to patents as this decreases inflammation and therefore symptoms.

The source is a primary source. WP:MEDRS requires secondary sources. Also, this 2006 literature review found "There is little available evidence to support lifestyle modification in AS." Sławomir
Biały 18:54, 16 January 2016 (UTC)

There are two paragraphs removed. Will the paragraph not referred to be reinstated? — Preceding unsigned comment added by 195.55.142.58 (talk) 08:57, 18 January 2016 (UTC)

I only removed the passage quoted above. Sławomir
Biały 12:20, 18 January 2016 (UTC)

The literatre review stated does not state "There is little available evidence to support lifestyle modification in AS." — Preceding unsigned comment added by 195.55.142.58 (talk) 09:06, 18 January 2016 (UTC)

Yes, it does. In the section "Lifestyle modification", p. 426. Sławomir
Biały 12:20, 18 January 2016 (UTC)

Lifestyle modification is an important part of AS management. For example, physiotherapy is considered an important part of the overall management of AS. — Preceding unsigned comment added by [[User:{{{1}}}|{{{1}}}]] ([[User talk:{{{1}}}|talk]] • [[Special:Contributions/{{{1}}}|contribs]])

Furthermore, the above-referenced literature review cited another study finding that diet did not help pain management. Diet studies are notoriously problematic. Sławomir
Biały 20:21, 18 January 2016 (UTC)

Please specify why the paragraph 'The London AS Diet was developed by Professor Alan Ebringer at the Ankylosing Spondylitis Research Clinic, Kings College, London. It is a low starch diet.' has been removed. — Preceding unsigned comment added by 195.55.142.58 (talk) 09:07, 21 January 2016 (UTC)

It was completely unsourced. Sławomir
Biały 12:09, 21 January 2016 (UTC)

HLA B27 test

No diagnosis for AS - not entirely correct. You can test for the protein created by the HLA B27 gene - this is how, after several years of misdiagnosis and ineffective treatment, my wife and I finally found the reason behind her back pain issues. Her levels came back seven times higher than normal when tested.

I am one of those people whose diagnosis was held up for many years because I failed to test positive for HLA-B27. I can identify one relative on my maternal side who probably had AS but she died decades ago so there is no hope of comparing my DNA with hers. According to Matthew Brown (Director of Genomics, Queensland University of Technology ), there are about 20 other genes that together or singly increase the risk of developing the disease in the presence of specific environmental pathogens and / or conditions. Where could someone like me go to be tested for the presence of these other identified risk-bearing genetic variants?

I would like to know if I have passed the risk along to my child.  — Preceding unsigned comment added by 2601:642:4100:4849:E56D:10C8:3CE9:DFC5 (talk) 17:32, 11 July 2018 (UTC) 

Ref

Which part supports "It is thought that in some cases a diet low in starches found in flour products and potatoes, and high in proteins and vegetables is of benefit for AS patients."? Doc James (talk · contribs · email) 21:57, 20 October 2016 (UTC)

References

Life expectancy?

User:Doc James changed my edit. As I read the review article, the evidence mostly points towards no difference in life expectancy. This is odd but consistent given the increased specific mortality data cited in the article. It's possible that the condition increases specific mortality from some causes, but also decreases others, so that there is no net decline in life expectancy.

Could James explain why his formulation is superior to mine? "About 30% of those affected have a reduced life expectancy." sounds like it's making the claim that patients come in two identifiable categories, and one of them does not experience any decline in life expectancy. I don't think there is any support for this two category claim. --Deleet (talk) 16:26, 1 November 2016 (UTC)

The categories don't necessarily need to be identifiable apart from one of them having reduced life expectancy. However it may be down to any number of factors, such as the speed at which the disease progresses or how well the patient adheres to treatment. What does the paper you use say? The one I see cited comes to an entirely different conclusion… Carl Fredrik 💌 📧 16:43, 1 November 2016 (UTC)

Ref says "It can be concluded that at least a third of the patients with ankylosing spondylitis have a severe course of disease and a reduced life expectancy."[10]

Unable to find the wording in the ref that supported the version you added. Doc James (talk · contribs · email) 01:29, 2 November 2016 (UTC)

On second reading, I can't find it either. Odd. Let's keep yours. --Deleet (talk) 01:25, 4 November 2016 (UTC)

K sounds good. Doc James (talk · contribs · email) 10:37, 4 November 2016 (UTC)

Is there any research on decreased morality due to suicide, pain medication overdose and physician assisted suicide? As an AS victim I wonder how much daily pain I can tolerate before death seems preferable. — Preceding unsigned comment added by 2601:642:4100:4849:E56D:10C8:3CE9:DFC5 (talk) 17:22, 11 July 2018 (UTC)

Relatively newly created umbrella term

IMO this belongs in the body of the article not as its own paragraph in the lead.

"Since 2009, Ankylosing spondylitis is a member of the more broadly defined disease axial spondyloarthritis, which is an the umbrella term created to better diagnose, treat and study less severe forms and early stages of ankylosing spondylitis. "

Others thoughts? Doc James (talk · contribs · email) 14:58, 2 March 2017 (UTC)

Opinion of User on rcde2 on the new umbrella term axial spondyloarthritis

I am currently working for the ankylosing spondylitis patient organization in Switzerland, where I am conducting literature research on current research topics and am in contact with Swiss rheumatologists. During my time here I have gotten the impression that axial spondyloarthritis already is a very important term for the following reasons:

1. High impact reviews on ankylosing spondylitis as well as management recommendations for the disease use the term axial spondyloarthritis instead of ankylosing spondylitis. The rationale behind it is to also include less severe and early forms of ankylosing spondylitis. Literature examples include:

2. Early stage patients so far have been in the disadvantage of not having a specific diagnosis and therefore often lacked the access to appropriate therapy. Due to the new term "axial spondyloarthritis" these patients can be diagnosed at a much earlier point and can therefore profit from better treatment options (see ASAS-EULAR management recommentadions for Europe ) . Since an early treatment has been indicative for a good response to TNF-a inhibitors and hence a slower radiographic disease progression, an early diagnosis is of great importance.

3. Even thought the FDA does not approve TNF-inhibitors for non-radiographic axial spondyloarthris (yet), they have agreed that axial spondyloarthris is an official disease term that includes ankylosing spondylitis.

Okay added a shorter summary to the lead based on that last source "It is also within the broader category known as axial spondyloarthritis." Doc James (talk · contribs · email) 02:43, 3 March 2017 (UTC)

References

Lancet

doi:10.1016/S0140-6736(16)31591-4 JFW | T@lk 09:53, 7 July 2017 (UTC)

Contradictory information on prevalence

Just want to throw in a suggestion for someone who is actively working on this page. There is contradictory information on prevalence. Early in the article, it says that the prevalence is estimated to be 0.1 to 1.8% of the population (a really weirdly odd range if you ask me). In the Epidemiology section, it gives a different range for the prevalence, a narrower range that seems more reasonable. I'll leave that for others to deal with. Rlitwin (talk) 03:14, 5 December 2017 (UTC)

Updated the body with the better ref found in the lead. Doc James (talk · contribs · email) 04:43, 5 December 2017 (UTC)

Contradictory information on Egyptian mummies

In the Introduction: "The condition was first fully described in the late 1600s by Bernard Connor, but skeletons with ankylosing spondylitis are found in Egyptian mummies.[8]"

In the History section: "Skeletal evidence of the disease ...was thought to be found in the skeletal remains of a 5000-year-old Egyptian mummy with evidence of bamboo spine.[46] However, a subsequent report found that this was not the case.[47]"

Ref 47 seems to be a more specific and therefore more authoritative source which contradicts ref 8 and ref 46. Suggest removal of statement from introduction, as the History section adequately and more accurately deals with the development of opinion on this topic. — Preceding unsigned comment added by 193.28.232.2 (talk • contribs) 11:01, 8 February 2018 (UTC)