symptoms over one month ago

As a medical student you will be able to assess this more than others.

At exactly the same age as you I was limping with a sore hip and my back and rib cage in so much pain.  I am now 50 years old and in very good shape, my father had the same disease and is badly affected so I know what it can be like. 

It has been established for many years that AS is more likely to be a cross reactive immune response to an antigen (often Klebsiella). 

If you look online for research / medical studies done by Dr. Ebringer (Professor at King College!) you will see that this is a real treatment for some people.

One thing you might want to try is to remove all starch consumption for about 1 to weeks to see if the inflammation subsides.   So no breads, corn / maize, rice - and also limit sugar consumption and do not drink grain based alcohol, so no Beers, Guinness or lager.

There are lots of people (many thousands!) on a this diet (or a variation) - details and another forum for ideas is on the KICKAS website.  

I hope you find some relief soon!

what doeas it mean to AS patient take nsaidds only .. and don't take tnf-inh ? is that means i will be tottaly sick and can't be a good doctor ..

tell me?? how can you buy tnf-inh and this is adream for us? :-(

Anti TNF drugs interupt the immune response and I am sure they do work well for some people.  But they do also stop the immune system from fighting infections too, so some people get side effects. 

The Klebsiella research is not really about infection - it is about an incorrect immune response to Klebsiella.  With AS this immune response can occur even when low levels are present - so not a true infection.

NSAID's dull the pain but will not stop the damage - there have been medical studies done on the role of NSAID in both AS and RA which show that long term use actually makes theses diseases worse.

This research in to NSAID fits in with the research from Dr. Ebringer in that they state in the NSAID research that they "increase gut permeability" - so they allow the transit of bacteria fragments (like Klebsiella) through the gut.

Based on the research - there seems to be a similarity in mechanism with other AI diseases.  Where the antigen is different - and the response and resulting disease can vary based on genetics.  HLA-B27 for AS.  HLA-DR for RA (different antigen, diffferent gene susceptibility),  HLA-DQ2 for Celiac (antigen is gliadin from gluten).

With celiac we know that if you remove the antigen (gliadin) then the disease process can stop or improve greatlly in virtually all cases.

We also know that fasting improves AS - and although difficult, in an emergency can be a temporary option to stopping a bad flare.  Obviously not a long term thing.  However - a starch free, lower carbohydrate diet is more sustainable and will 'starve' specific gut flora (including Klebsiella).

You can't withdraw Klebsiella proteins from our diet (like a Celiac can with Gluten) - but you can impact them with what you eat.

now the last question ..

how can you stay healthy after all yaers .. what is the real cause ?.. is that sport or tnf-inh or free stratch diet .. i am still young doctor ..

finally .. how can my AS imbroves if i don't take tnf-inh?

I am really afraid of curving :-(

I am gluten free, low carb.  I never take NSAID even if I have a headache.

I do a lot of stretching and find gym / swim helps me too - but it is the diet doing the work not the exercise. I run sometimes, I ran a half marathon at age 30 and then again at 40 I did another half marathon.

With the diet - The exercise gives you strength to stay upright and fight the occassional flare up.

With my diet I am 75% better over 90% of the time.  I get occassional stiffness using from over eating sugar based food and starches.

It is seen as bit of a fad by some - but gluten free as part of my approach changed my disease completely.  it also help my fatigue and concentration level too.

My father has a curved back and I was always concerned too - the diet changed my disease to the point where I can feel the damage done by previous flares but the muscles stiffness and pain is pretty much gone most of the time.

I have x-rays showing bone spurs on the back ribs. My front ribs lump out on the left hand side - so i know I have the potential for my disease to be much worse!

Try a protein (meats) / salad / non-starch vegetable based diet for at least 2 weeks and see if your arthritis improves.   Stay away from breads of all kinds during this trial as they feed the klebsiella but gliadin also causes intestinal permeability - regardless of celiac.

Go and speak to a good natropathic doctor - A good gut balance is key to this disease.

I will apply your advices , do atrial of diet , ask god to be the solve .

I still have many questions :-) :-)

so i will be pleased to Talking munificence on whatsapp .. my phone number /+963934705021/

what astrang order :-) ...

anyways thank you very much O:-)

I will apply your advices , do atrial of diet , ask god to be the solve .

I still have many questions :-) :-)

so i will be pleased to Talking munificence on whatsapp .. my phone number /+963934705021/

what astrang order :-) ...

anyways thank you very much O:-)

I will apply your advices , do atrial of diet , ask god to be the solve .

I still have many questions :-) :-)

so i will be pleased to Talking munificence on whatsapp .. my phone number /+963934705021/

what astrang order :-) ...

anyways thank you very much O:-)

I can recommend 'The autoimmune Solution' it helped a lot with my understanding.  I am convinced diet is the anwer.   I am 30 days dairy free, gulten free, sugar free, etc and still am the same, but who knows how worse I would be if not for my improved diet.  The next medical step ofcourse is Sulfasalazine and then Entanercept.  The long term effects (assuming they even work without serious side effects) of which are not a bright future.  Each of us has to make out own choices.

All the best.

first of all you have got pretty cool english and don't worry about it. Second you don't have to worry about AS as well. The only thing is that you must keep mobilizing yourself. Take anti-inflammatory meds (only where pain is worse) and have some rest. however don't forgot to cousult doc. Just paly and move as much as you can. and best of luck for your exams. Just chillll....

I have gone to doctor and did CRP & ESR which was all normal , i told the doctor that even if it was normal i can't stand my pain , he tell me that i don't have AS because crp is not elevating it is so normal , he reject to do an x-ray!!

my chest pain is very severe ..

i will do mri after few days