What is ankylosing spondylitis?
Ankylosing spondylitis (or AS for short) is a chronic, progressive, painful inflammatory rheumatic disease, which affects the spinal joints, in particular those at the base of the spine (the sacroiliac joints and the lumbar spine). It is one of the seronegative spondyloarthropathies, others being Reiter's disease, Behçet's disease, psoriatic arthropathy, and arthropathy associated with inflammatory bowel disease (Crohn's and ulcerative colitis). Spondylitis means inflammation in the joints of the spine. The word spondylitis originates from the greek word for vertebra ("Spondylos"). As the inflammation goes and healing takes place, bone grows out from both sides of vertebrae and may join the two together. The stiffening this causes is called ankylosis.
Symptoms of ankylosing spondylitis
The symptoms of ankylosing spondylitis are usually found in patients aged between 16 and 35. Patients usually have chronic pain and stiffness in the lower part of the spine. Pain is often severe on rest, and improves with physical activity. The exercise during active phases of inflammation is not advisable.
Pain may be felt in the lower back, buttocks and the back of your thighs. At first it may be intermittent or on one side only, or sometime alternate between sides. however, within a few months it generally becomes chronic and is felt on both sides (bilateral).
Aches and pain in the neck, shoulders, chest and hip may follow. Chest expansion is often markedly reduced. The first complaints may not be in the back at all, but in the hip, knee or foot ankle. sometimes just a swollen knee or swollen foot ankle.
Some people with AS have only transient episodes of back pain with periods in between (remissions).Sometimes you may have one or more episodes of acute inflammation of the eye (acute iritis - symptoms include reddish eye with high sensitivity to light and acute pain) or of the bowel(Crohn's disease or ulcerative colitis). People with ankylosing spondylits usually have recurring mouth ulcers.
The symptoms are typically worse on waking up in the morning (‘morning stiffness’) because a long period of inactivity usually makes the pain and stiffness worse.
Triggers of ankylosing spondylitis
The ankylosing spondylitis may likely be caused by multiple factors. Triggers may include genitic and non genetic including environment factors (like cold climate). Few of the causes are listed below.
HLA - B27
There is a substantial evidence to prove that HLA - B27 has a direct role in enhancing genetic vulnarability to ankylosing spondylitis. Most people with ankylosing spondylitis have HLA - B27 gene. Around 90% of people with ankylosing spondylitis have HLA - B27 gene. It is very important to note that all the people with HLA - B27 do not develop ankylosing spondylitis.
Gut infection
Ankylosing spondylitis may be triggered by gut infection with Klebsiella bacteria. Though it is not conclusively proven circumstantial evidence suggest this. Klebsiella bacteria and HLA-B27 have similar amino acid sequence. And hence, our body continues to produce antibodies even after gut infection is healed.
The ankylosing spondylitis may likely be caused by multiple factors. Triggers may include genitic and non genetic including environment factors (like cold climate). Few of the causes are listed below.
HLA - B27
There is a substantial evidence to prove that HLA - B27 has a direct role in enhancing genetic vulnarability to ankylosing spondylitis. Most people with ankylosing spondylitis have HLA - B27 gene. Around 90% of people with ankylosing spondylitis have HLA - B27 gene. It is very important to note that all the people with HLA - B27 do not develop ankylosing spondylitis.
Gut infection
Ankylosing spondylitis may be triggered by gut infection with Klebsiella bacteria. Though it is not conclusively proven circumstantial evidence suggest this. Klebsiella bacteria and HLA-B27 have similar amino acid sequence. And hence, our body continues to produce antibodies even after gut infection is healed.
