Xiaogang is 14 years old, a year ago when he woke up in the morning always clamoring that his back hurt and his buttocks hurt, his mother suspected that he was not trying to be lazy and did not like to study, Xiaogang looked aggrieved. A year has passed, Xiaogang still said that the waist is sore and sleepy discomfort, after a class down and said sitting waist pain. A few days ago, Xiaogang had diarrhea for a few days, and his right knee joint inexplicably swelled up.
What is the incidence of ankylosing spondylitis in China and abroad?
The prevalence of ankylosing spondylitis varies from country to country. In foreign countries, the prevalence is 0.05% – 0.2%. In China, it is 0.3%. This means that 1 in 1000 people have the disease —-3. Men are 5 times more likely to have the disease than women. Women have less severe symptoms than men. The age of onset is 13 – 31 years. The peak age is 20 – 30 years. It is rare after 40 years of age and before 8 years of age.
What exactly is ankylosing spondylitis? Is it hereditary?
What is its pathogenesis? Ankylosing spondylitis belongs to the category of rheumatic diseases. It is a chronic inflammatory disease that mainly affects the sacroiliac joints, spinal prominences, paraspinal muscles and soft tissues, peripheral joints, and can be associated with extra-articular manifestations. It is not a genetic disease, but it has a genetic predisposition. For example, if a person has grandparents, fathers, uncles, or cousins who have the disease, that person has a high chance of getting the disease. Genetic relationship (related to human leukocyte B27 antigen, HLA-B27 positivity rate is 6-8% in normal people and about 90% in AS patients), microorganisms (viruses, bacteria, inflammatory factor stimulation) disrupt the immune system in the body.
Q: Which groups of people are susceptible to ankylosing spondylitis? What are its predisposing factors? What should we do to prevent it in our daily life?
Long and thin body type, weak adolescents, family history of the disease, repeated upper respiratory infections in early childhood, sinusitis, gastrointestinal to dysfunction, urinary tract inflammation, skin diseases, or irregular living habits, often staying in a humid environment, taking a cool shower after sweating, lying on a concrete floor or a wooden board to keep cool in the heat.
Predisposing factors: mainly genetic factors, environmental factors, inflammatory factors account for the main. That is to say, genetic susceptibility combined with environmental factors, inflammatory factors and other external factors, easy to induce.
I often tell my patients, if there is a family history of this is the internal factors. But it is perfectly possible to grasp the external factors. Remind parents to wear thick clothes in winter during the early years of their children to avoid catching cold, recurrent colds, sinusitis, gastroenteritis, and early treatment if there are symptoms of appeal to prevent inflammation from spreading.
Remind teenagers not to blow against the air conditioner in the heat, do not lie on the concrete, wooden boards to cool off.
Remind high school students not to take a cool shower after playing ball or sweating from activities. Don’t be sedentary and participate in outdoor activities properly.
Q: What are the symptoms of having ankylosing spondylitis? Do all patients suffer from spinal deformities? Can it be detected early in the early stages?
Early symptoms of ankylosing spondylitis are mild, intermittent and insidious, and can be easily misdiagnosed. There have been cases of misdiagnosis as growing pains, lumbar disc herniation, lumbar strain, etc.
The following symptoms should be highly suspected.
1.Medial joint: intermittent low back pain, lumbar paravertebral muscle pain, especially night pain, sleep disturbance, low back stiffness at 5 – 6 o’clock in the morning, and the pain stiffness can be reduced after morning activities.
2. Peripheral joints: hip, hip, single knee, ankle, toe joints. 3. Thoracic ribs, Achilles tendon, heel, tendon attachment enditis.
3, extra-articular manifestations: eye inflammation, skin damage, oral mucosal lesions.
Not all patients will develop spinal deformities. If they do not receive standardized treatment in the early stage, in the later stage, the spine becomes stiff and restricted in all directions, and they cannot bend down to pick up things. The peripheral joints are mainly involved in the hip joints, with restricted movement, bone destruction, leading to difficulties in life and work, and a poor prognosis. Eventually, hip joint replacement is required.
Q: What are the medical treatments available for ankylosing spondylitis? Can it be completely cured?
There are two main methods of medical treatment: First: traditional medication: oral non-steroidal anti-inflammatory analgesics. Representative drugs: Fotarine, Ankylosing, Ciloxib, etc. The characteristics of this class of drugs: rapid control of pain symptoms, we call the first-line drugs, drugs to treat the symptoms. Slow-acting drugs, immunosuppressants: representative drugs: lutetrapyridine, leflunomide, thalidomide, etc. The characteristics of this class of drugs: delaying the progression of the disease, we call the drug to cure the root cause.
Second: injectable biological agents (anti-tumor necrosis factor). Representative drugs: Yicep, Enzyme, Class A, etc. The characteristics of this class of drugs: strong targeting, good efficacy, especially for patients with stiffness and pain in the mid-axis joints and low back, the efficacy is immediate and the symptoms are treated at the same time. Of course, the application of such drugs is more expensive, but without oral drugs, it can reduce the stimulation of the stomach. They can be applied as long as there is no tuberculosis, active hepatitis B, and the virus is not replicating.
Depending on the condition, choose a treatment plan. Regardless of which of the above treatment options is taken, educating patients about physical exercise should not be neglected. Some patients are afraid to move because of pain, and at a later stage, fibrosis of the lumbar spine and destruction of the hip joint occur, and in time, they do not have pain, but the joint function is lost, which is a pity. Therefore, we advocate the principle of early diagnosis and treatment, standardized treatment and individualized treatment, which can both control the symptoms and slow down the progress of the disease, so that patients have more confidence in exercise.
Q: What should patients with ankylosing spondylitis pay attention to in terms of diet? What are the best dietary treatments?
There are no special dietary restrictions for patients with ankylosing spondylitis. It is recommended to eat more fresh fruits, vegetables, grains and cereals, and foods rich in calcium content. Because ankylosing spondylitis has varying degrees of bone destruction, it is important to pay attention to the prevention of osteoporosis. As long as the nutrition is balanced and the appetite is good, you will have resistance and will be able to fight the pain. Most patients have a poor appetite due to pain and long-term oral medication, so it is important to remind parents and friends to try to adjust their children’s meals to avoid anemia.
Q: What other things should I pay attention to when living with ankylosing spondylitis?
You can participate in swimming in summer because it is good for the back muscles and limb joints. Sleeping has buoyancy and can reduce pain. This is the reason why children are born in water now. Winter dress code to keep warm, some young boys wear thin clothing which are not desirable. Some young girls wear short tops, easy to make the waist, sacroiliac joint cold, wear short skirts so that the knee joints are frozen, are not good for disease. We also advocate doing a set of lumbar and back muscle exercise gymnastics before getting up before bed. I have such a gymnastics chart here.
Q: Patients with ankylosing spondylitis are prone to negative events in their lives, which can cause depression, anxiety and panic, and are not good at talking to others. Is this the case? What personality traits predispose people to ankylosing spondylitis? _
AS patients suffer from pain, bad mood, temper, and fewer friends, especially in adolescents who are already in a rebellious phase, and when combined with the stress of the disease, the pressure of studying, and parental nagging, they become more depressed and their immune system is disrupted.
Other doctors do not pay attention to psychological treatment, exaggerating the danger of the disease, so that patients fear, coupled with the economic burden, thus losing confidence in treatment and the courage to live, which is undesirable. So friends suffering from ankylosing spondylitis should be open-minded and face it correctly, neither to take it lightly, full of care, nor fear of psychological depression. The actual fact is that you will be able to get to a specialist hospital as soon as possible for standardized treatment.
The most important thing is that you should be able to get a good idea of what you want to do.
Q: Are women also prone to ankylosing spondylitis after giving birth? What should I pay attention to?
Yes. The immune system of women is weakened at this time after childbirth, and bacteria and viruses can easily invade the body, making them susceptible to pelvic inflammatory disease, vaginitis, cervicitis, gastroenteritis, and urinary tract inflammation. The chance of ankylosing spondylitis is higher than that of normal people.
Note:
1. Pay attention to the hygiene of the genitourinary system during the perinatal period to prevent infection.
2, pay attention to keep warm. Just after the birth of a child, the body is weak and prone to sweating, and at night many times bare chest and shoulders are very vulnerable to wind.
3, strengthen nutrition, balanced nutrition, enhance body resistance.
4, listen to more music, jokes to keep the mood happy.