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What Causes Ankylosing Spondylitis?

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Posted on Mon, 8 Jun 2015
Question: Hello- i'm writing this in hopes that someone will help me find an answer to my dad's ailments...other than the diagnosis of Fibromyalgia. For as long as I can remember he has suffered from chronic pain in his joints, back and neck...actually his entire body. Theres a new swollen extremity almost everyday...when one subsides another flares up. He also suffers from chronic sinus infections and abdominal pain. In the past we were told he had RA, anklosing sponlyitis, fibromyalgia, etc. He's tried enbrel, and humira and stayed sicker on those medications than was worth him taking. He's currently on (i apologize for my spelling) methotrexate, prednisone, Plaquinel, Effexor, sulfasalazine, and over the counter flonase and nexium. Today while at his doctors appointment, it baffled me that the doctor could not give him any answers other than..lets up your meds. She said his blood test showed a negative test for RA and a Positive Result for HLA-B27 and an elevated TSH count. Additional medical information, medications, treatments, surgeries, etc: Pain pills(which he doesn't take anymore), physical therapy, pain and anti-inflammatory creams, shoulder surgery, knee surgery, deviated septum surgery. Broken neck in car accident 25 years ago. Also diagnosed with COPD...grew up in a household where the father consistently smoked.
All we want is for him to feel better.... its very difficult to see the man that used to play baseball and hunt, run, jump and swim; be in so much pain that he can't get up to come to the dinner table or is hurting so bad that he can't hold his grandchildren like he used to. Please help......
doctor
Answered by Dr. Naval Mendiratta (43 minutes later)
Brief Answer:
Ankylosing Spondylitis

Detailed Answer:
Good evening

Thank you for writing on health care magic

I have gone through your history, and considering the treatment he has received there is no doubt about the diagnosis of Ankylosing spondylitis, as the HLA B 27 is positive as well. I would like to know a few more details about him before I can comment you further. I understand your agony to see him suffering, but we need to be sure where we are heading before we step up the treatment...

1. When you say the extremity is swollen, what exactly are you referring to? Is it the joint swelling or muscles?

2. What were the side effects of Enbrel/Humira he experienced?

3. Current dosage of MEthotrexate, Sulfasazline, Plauqenil and PRednisolone?

4. Does he still experience night pains and early morning stiffness affecting the back and the neck?

5. How were the last ESR and CRP results when tested??

6. Is he losing any weight or appetite?

Do let me know these queries. First thing we need to distinguish here is , is all the pains due to inflammatory arthritis or due to Fibromylagia. The treatment has to be modified accordingly.

I will try to help you out in the best way I can

Regards
Dr Naval

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
doctor
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Follow up: Dr. Naval Mendiratta (10 minutes later)
Thank you very much for the quick response. I will have the specific answers as soon as I get to his home to speak with him. One other question... with the abdominal pain, chronic sinus infections... do those need to be addressed separately?
doctor
Answered by Dr. Naval Mendiratta (16 minutes later)
Brief Answer:
Sinusitis

Detailed Answer:
Good evening

Well the sinus infections can be a not specific one. As for the abdominal pain, it can very well be a part of uncontrolled Ankylosing spondylitis. AS is known to be related to inflammatory bowel disease or it can cause changes in the intestine as well which can cause intermittent pains and loose stools. Once the disease is controlled, it all responds as well..Do let me know his history about the frequency of motions/blood in stools/and how severe are the abdominal pain.

Any last blood reports if you could attach, that would be helpful too

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. Vinay Bhardwaj
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Answered by
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Dr. Naval Mendiratta

Rheumatologist

Practicing since :2007

Answered : 754 Questions

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What Causes Ankylosing Spondylitis?

Brief Answer: Ankylosing Spondylitis Detailed Answer: Good evening Thank you for writing on health care magic I have gone through your history, and considering the treatment he has received there is no doubt about the diagnosis of Ankylosing spondylitis, as the HLA B 27 is positive as well. I would like to know a few more details about him before I can comment you further. I understand your agony to see him suffering, but we need to be sure where we are heading before we step up the treatment... 1. When you say the extremity is swollen, what exactly are you referring to? Is it the joint swelling or muscles? 2. What were the side effects of Enbrel/Humira he experienced? 3. Current dosage of MEthotrexate, Sulfasazline, Plauqenil and PRednisolone? 4. Does he still experience night pains and early morning stiffness affecting the back and the neck? 5. How were the last ESR and CRP results when tested?? 6. Is he losing any weight or appetite? Do let me know these queries. First thing we need to distinguish here is , is all the pains due to inflammatory arthritis or due to Fibromylagia. The treatment has to be modified accordingly. I will try to help you out in the best way I can Regards Dr Naval