Ankylosing Spondylitis (AS): Information on symptoms, underlying causes, and further details
Ankylosing spondylitis (AS) is a chronic inflammatory disease that primarily affects the spine and sacroiliac joints, impacting the overall health and function of those affected. This article aims to provide an overview of the common complications associated with AS, treatment options, and strategies for managing the condition.
**Spinal and Skeletal Complications**
One of the most significant complications of AS is spinal fusion, or ankylosis, which can lead to severe stiffness and loss of spinal mobility, making bending or twisting difficult. This can result in a characteristic “question mark posture” or kyphosis. AS patients are also at an increased risk of developing osteoporosis, which, combined with spinal fusion, can lead to a higher risk of vertebral fractures. The brittle, fused spine is more prone to fractures, even after minor trauma.
**Physical and Postural Effects**
Impaired mobility and postural changes are common in AS patients. Loss of flexibility in the spine and other joints impacts daily activities and overall quality of life. Progressive spinal fusion can result in a stooped or hunched posture, reducing the ability to stand erect or look forward. Reduced movement and pain can also lead to muscle wasting, particularly in the trunk and pelvic muscles.
**Systemic and Extraskeletal Complications**
AS is associated with an increased risk of cardiovascular events, including heart disease and aortitis, due to chronic inflammation. Reduced chest expansion from spinal involvement can impair lung function and increase susceptibility to respiratory infections. Some patients may experience inflammatory bowel disease, particularly in those with severe axial disease.
**Mental Health and Quality of Life**
Chronic pain, physical limitations, and the impact on daily life can lead to mental health challenges, including depression and anxiety. Persistent inflammation and disrupted sleep due to pain may contribute to significant fatigue.
**Other Complications**
Eye inflammation, known as uveitis, is a common extra-articular manifestation of AS and can lead to vision impairment if untreated. Immunosuppressive therapies used in AS management may increase susceptibility to infections, such as upper respiratory and skin infections.
**Treatment and Management**
Early diagnosis, regular physical therapy, pharmacological management, and lifestyle modifications are crucial to mitigate these complications. Treatment options for AS can include physical therapy, occupational therapy, exercises, certain drugs, and surgery in rare cases. Local steroid injections can provide pain relief for people with AS. Oral small molecules such as tofacitinib (Xeljanz) are also drug options for AS.
Tumour necrosis factor (TNF) inhibitors are drug options for AS, with examples including adalimumab (Humira), certolizumab (Cimzia), etanercept (Enbrel), golimumab (Simponi), and infliximab (Remicade). Other biologic treatments for AS include secukinumab (Cosentyx).
AS often begins between ages 17 and 45, but it can also develop in children and people who are much older. Symptoms of AS often include spine and midback pain, stiffness, a loss of mobility, pain that worsens with rest and during the night, pain that improves with movement, pain that affects other joints, fatigue, appetite loss, vision changes, abdominal pain and diarrhea, trouble taking deep breaths, and symptoms that may affect the ribs, shoulders, knees, ankles, feet, and tendon insertions at the heel, top of the shin bone in the lower leg, Achilles tendon, and sternum.
Imaging tests for AS may include X-rays, MRI scans of the sacroiliac joints, ultrasound, and CT scans. In severe cases, AS can cause the vertebrae of the spine to fuse, or "ankylose," making performing everyday tasks challenging. About 90% of people with AS have the HLA-B27 gene.
It is essential to consult a healthcare professional for accurate diagnosis and treatment. With the right care and management, it is possible to live well with AS.
- Ankylosing spondylitis (AS) is a type of chronic inflammatory disease that can lead to complications such as HIV, diabetes, colitis, crohns, psoriasis, hepatitis, and ulcerative diseases due to the body's immune response.
- AS patients are at increased risk not only of spinal fusion and osteoporosis but also of developing other chronic diseases like asthma and spondylitis, increasing their vulnerability to various health-and-wellness issues.
- The progressive spinal fusion associated with AS may result in obesity due to the difficulty in engaging in physical activities, which can further exacerbate existing health problems.
- It is crucial to predictive monitor AS patients for potential complications using science-backed methods, as timely intervention can help prevent the escalation of chronic diseases.
- Treatment strategies for AS often involve medications like Prep (daily oral pre-exposure prophylaxis for HIV prevention) and Tumour necrosis factor (TNF) inhibitors, such as adalimumab, certolizumab, etanercept, golimumab, and infliximab.
- While treatment and management can help mitigate complications, mental health issues, such as depression and anxiety, may still arise from chronic pain and physical limitations associated with AS.
- Early diagnosis and regular monitoring of mental health are important to maintain overall quality of life when dealing with chronic diseases like AS.
- Aside from physical symptoms, AS can also manifest in extraskeletal complications such as eye inflammation (uveitis) and an increased susceptibility to infections due to immunosuppressive therapies.
- Adequate management of AS requires a holistic approach, encompassing medical-conditions care, lifestyle modifications, and support for both physical and mental well-being, as part of the broader health-and-wellness picture.
- Given the potential for severe complications and a variety of health-and-wellness implications, anyone experiencing suspicious symptoms should seek the advice of a healthcare professional without delay.
- With timely and appropriate care, it is possible for individuals with AS to live well and manage their condition effectively, leading to improved quality of life and better disease outcomes.
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