How gut health affects my ankylosing spondylitis pain

Confession time: I wasn’t always a big advocate for gut health. I’m a skeptical person, so I mentally categorized it with unproven alternative therapies and fad diets. I’ve always eaten pretty healthily, but I didn’t make the connection that what I ingest — even if generally considered healthy — could increase pain in completely different parts of my body.

After I was diagnosed with ankylosing spondylitis (AS), however, I slowly realized that what I ate or drank could have a big impact on my pain levels.

Growing up, I associated food and flavors with happiness. As a girl, I loved helping my dad cook family dinners like chili with warm flatbread or butter-pastry Cornish pasties. Mum baked crusty sourdough bread every day, and as a starving college student, I’d salivate at the thought of it.

But even fresh, home-cooked food can make my AS pain worse. It’s been quite a journey to discover which foods allow my gut to heal, but continuing a specific diet that controls gut bacteria has drastically reduced my stiffness and joint pain.

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How can gut health affect AS pain?

Ankylosing spondylitis is an autoimmune disease, which means the immune system is malfunctioning and attacking the body instead of protecting it. For those of us with AS, this causes pain and damage in our joints, particularly the spine and sacroiliac joints.

I was surprised to discover that a large percentage of our immune system resides in our gut. According to a 2014 article published in the journal Autoimmune Diseases, “The gut, with a surface area of approximately 200 square meters, is where we come into greatest contact with the outside world and it follows that the gut also has the largest collection of immune cells, consisting of 70% of all lymphoid tissues in the body.”

It makes sense for AS to be linked to gut inflammation. As the Arthritis Foundation website notes, AS is in the spondyloarthritis family, which also includes the inflammatory bowel diseases ulcerative colitis and Crohn’s disease.

An article published in 2021 in the journal Experimental and Therapeutic Medicine says, “A high percentage, up to 70%, of patients with AS have subclinical intestinal inflammation.”

If we have a damaged, leaky gut (also called increased intestinal permeability) and our intestinal barrier is compromised, a greater number of microbes and bacteria can bombard our immune system and trigger an increased autoimmune response.

In her book “The Keystone Approach: Healing Arthritis and Psoriasis by Restoring the Microbiome,” molecular biologist Rebecca Fett writes, “The resulting immune activation is not limited to the gut. The end result is systemic inflammation and damage to the skin and joints.”

How I’m working on healing my gut

So what can we do to heal the gut, allow the intestinal barrier to repair, and help regulate our immune system?

Following are a few steps I’ve taken. But please note that you should always speak with your doctor before making any changes to your diet or medication regimen.

• Avoid sugar and starch, both of which feed bad bacteria and allow them to flourish in the gut
• Follow the no-starch diet for ankylosing spondylitis
• Quit foods that are inflammatory for me, including gluten, nightshades, and soy
• Invest in a high-quality probiotic
• Reduce my alcohol intake
• Avoid overuse of nonsteroidal anti-inflammatory drugs like ibuprofen, which can damage the stomach lining
• Eat fiber to feed the good bacteria
• Take collagen and L-glutamine supplements to repair my gut lining
• Consume olive oil daily to reduce inflammation

Taking these steps has greatly reduced my daily pain levels and the severity of my AS symptoms. The no-starch diet has worked so well for me that when my husband, Dave, was diagnosed with AS a year after me, I thought, “Good, I know how to help you feel better!” Pretty surprising to think “Good!” when it comes to an AS diagnosis, right?

One of the best parts of improving my gut health has been gaining some control over AS. Sure, I muck up occasionally (I do enjoy a glass of wine) and pay for it with more joint pain. But generally, I feel more energetic and less stiff and sore when I look after my gut health.

If you have AS and are interested in learning more about healing the gut, I recommend Fett’s book as a valuable and research-packed place to start.

Note: Ankylosing Spondylitis News is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those of Ankylosing Spondylitis News or its parent company, Bionews, and are intended to spark discussion about issues pertaining to ankylosing spondylitis.