Hi, Stuart:

do you reckon the low starch diet would curb the damage to my spine in the long run?

I absolutely believe that diet can prevent the spinal damage; I have met at least two people with AS who avoided severe skeletal changes: Carol Sinclair and George McCaffery (George introduced Carol to Professor Ebringer, and she was subsequently diagnosed by Ebringer with "Pre-AS" because she has no SIJ deterioration).

For my own case and advanced disease, diet alone was not very effective, but it took strict diet in combination with antibiotics to eliminate typical AS symptoms. I regret that I could not avoid more skeletal damage and I'm stuck with osteoporosis after so many years of mis-treatment.

Most drugs offer a false economy, and while I was taking the NSAID Voltaren, I read and re-read the literature inside the boxes and the numbers changed radically from one month to the next and I charted out the implications. Ok, start with a six week trial and 11% of subjects experience severe gastrointestinal complications, then 18 weeks and 25% and so on learning more with larger sample sizes. It was my conclusion that, eventually, almost every person taking these drugs would experience "severe gastrointestinal complications."

At that time, I did not know that AS was caused by the bowel germ, but in damaging my gut with NSAIDs, I knew that my AS greatly accelerated--only five years after starting NSAIDs my neck locked up and I had kyphosis. Regret also that I was a vegetarian, as in my story, exacerbating the already bad effects of the NSAIDs.

I do encourage You to try and eliminate as many starches from Your diet as possible, and You can perhaps monitor this, if Your ESR is related to disease activity (in over 40% of ASers this is not the case), since this would be a solid--non-subjective--measure of the value of these dietary changes. You should not need any drugs, but if You decide that something is required, sulfasalazine (enteric-coated; Azulfidine-EN) is a very useful DMARD.

My opinion of NSAIDs versus the biologic drugs is that NSAIDs are really much more dangerous--yes the anti-tnf-a drugs do result in some complications, but these are many times more rare than NSAID problems. If something like Enbrel can work as an adjunct with diet, it can be a very successful treatment. I know a lady who has been on Enbrel for over ten years with great results because she decreases her dosage around times when she is more strict with diet, and she has not developed any resistance to Enbrel. These are very clever drugs that offer great results for some people. However, they do not treat the cause of AS as do antibiotics and diet.

Have a HEALTHY and fun winter down there,

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