Hi Doc, I Have A Friend Being Diagnosed With Ankylosing

Posted on Fri, 8 May 2020

Question: Hi Doc, I have a friend being diagnosed with Ankylosing spondylitis. His HLAB 27 test is positive and ESR rate is also very high. We have been told that there is no treatment option available in XXXXXXX for this; I don't know if that's true. Please advise. Also in case there isn't any treatment available then what should we do? Any lifestyle adjustments that we must make? Looking forward to your guidance. Thank you

Answered by Dr. Naval Mendiratta (1 hour later)

Brief Answer:
Ankylosing spondylitis

Detailed Answer:
Good evening

Thank you for writing in health care magic

Well firstly to answer your question ,treatment options in XXXXXXX and the world are the same. XXXXXXX has all the advanced treatment available for this disease.But saying that not every patient needs heavy treatment. I have gone through your reports. ESR is mildly high and HLA B 27 is positive which may be the reason for arthritis.

I would like to ask you a few more details before guiding you to the treatment

1. Where is his pain more.
spine or the other joints like knees ankles?

2. does he have any night pains?or difficulty in turning position

3. Any early morning stiffness?

4. any history of frequent loose stools or eye redness

5.. How frequent he has to take pain killers?

do let me know these queries and would guide you further

Regards
dr naval

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Naval Mendiratta (17 hours later)

Thank you for your concern Sir. The answers of your questions are as following :

Q: Where is his pain more. Spine or the other joints like knees ankles?
1. Pain is more in lower back and neck only

Q: Does he have any night pains?or difficulty in turning position
2. Yes, it is difficult to turn positions during sleep

Q: Any early morning stiffness?
3. No early morning stiffness. Pain increase as I do work after morning

Q: any history of frequent loose stools or eye redness
4. No history of frequent loose stools but many times my eyes had redness during school days, I mean at the age of 15-18.

Q: How frequent he has to take pain killers?
5. I don't take any pain killer now from last 2 months, before that I used to take pain killer once in a week

Thank you Dr. Naval

Answered by Dr. Naval Mendiratta (3 hours later)

Brief Answer:
Further course

Detailed Answer:
Dear XXXXXXX

Thanks for your reply

Well I guess the involvement is mostly limited to the spine only for now. As for the eyes , it is difficult to say if it was due to HLA B 27 or some other allergic problem.

As such with a limitation of unable to examine you, it is very difficult to comment how aggressive your disease is or not and I will need X rays of the spine as well to be sure your disease is not progressing.

But other than that, one thing I can assure you there are all the best treatment available in our country. For mild symptoms we prefer Sulphasalazine and SOS pain killers. You are already on 500 mg BD which is a mild dose. If you are tolerating it increase it to 1000 mg twice daily. Pregab NT I am not much in favor of it as we use it more for disc problem. For night pains take Tab Nucoxia 90 mg once daily for 7 days.

Secondly, include daily exercise in your routine. With the lockdown it may not be possible but try brisk walking in your home and little stretching.
90 % percent people do well with exercises with very few needing life long treatment. But yes, 100 percent I will be in a position to comment after examining you

Do let me know for more queries

Regards
Dr Naval

Note: For further information on diet changes to reduce allergy symptoms or to boost your immunity, Ask here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar