Hey, Chris:

Would something like the following help?--

This material is an opinion, based upon the research done at Kings College, London, by Professor Alan Ebringer and colleagues and his 20+years clinical experiences at The Middlesex AS Clinic.

In 1983, Professor Ebringer began using a starch-excluding diet, The London AS Diet to help patients reduce symptoms of active AS. His subsequent studies, and vast clinical experience, provided clear evidence that such a diet was key in managing this disease.

Ebringer’s LSD (colloquially "Low Starch Diet") was easy to follow, long-term, and intended to be used in conjunction with conventional medical treatments and drugs, especially sulfasalazine-EN (enteric-coated), one of the best DMARDs then available for treating AS.

The diet focuses principally upon a scientific finding (not yet accepted by the entire scientific community) that the common bowel germ, Klebsiella pneumoniae, causes AS.

When eating a diet particularly rich in refined carbohydrates, the residue that makes it into the colon provides an optimum substrate for bacterial growth, and this germ blooms, increasing their numbers many times. Depending upon the character of the bowel contents, it is statistically more likely that the greater numbers of bacteria will infiltrate through the lesions and potentially increase disease activity.

Another factor in AS is a permeable gut, whether there are obvious lesions or “Crohn’s-like microlesions” as some researchers have observed. The germ has access to our secondary immune system through these lesions.

The mechanism of molecular mimicry accounts for the production of the features of AS, predominantly cellular death specific to those collagens rich in the outer surface protein HLA B27 (or structurally similar): Collagens I, III, IV, and V.


DIET and Ankylosing Spondylitis

The AS diets are essentially three degrees of inconvenience, depending upon an individual’s tolerance for the presence of this germ:

The London AS Diet (LSD) by Professor Alan Ebringer
The IBS Low Starch Diet (NSD; No Starch Diet) by Carol Sinclair
NSD and No Dairy by the Orthodox-strict AS Community

It should be apparent that results of diet are always subjective, unless there is a good gauge with which to monitor disease activity. The method employed by Ebringer et al monitored the antibodies to the bacterium, IgA-Kp (Immunoglobulin A, specific to Klebsiella pneumoniae). It was easy to establish a baseline and measure the hard numbers to see what affect diet or any drug was having on disease activity. Unfortunately, this method was never commercialized, but has been developed as a scientific laboratory standard measurement in almost twenty different countries.

In each of these regimens, the perceived goal is to eliminate the food upon which the germ that causes AS thrives: Starch. This germ can also ferment milk, so lactose, galactose and other milk components are potentially problematic for some individuals.

Well before 1978 Giraud Campbell also began using a starch-excluding diet in all types of arthritis, but especially interesting is some of his patients with wonderful results had “Marie-Strumpell’s” disease.

Campbell did not have the scientific reasoning behind why his diet worked for Marie—Strumpell’s patients, but he promoted his regimen for everyone with arthritis in general, as does Joseph Mercola, who has observed that grains or grain-based diets are particularly arthritogenic.

Also independent from these, Dr. Jean Seignalet had substantial results in his clinical experiences, excluding grains especially for his patients with AS.

And Jackie LeTissier ("Food Combining for Vegetarians") overcame her AS by managing the starch in her diet and perhaps managed to even remain vegetarian by a method of food combining.

There are even more references to starch-reducing diets and AS, Reiter’s Syndrome, and other diseases within this family, but these are the most recent and prominent.



Nota Bene: I am not a medical doctor, and my views do not represent the opinions of the SAA
AS Resources
My Long, Boring AS Story
Professor Alan Ebringer Diet and AS