Ankylosing spondylitis


Ankylosing spondylitis

Description of Bechterew’s disease

Ankylosing spondylitis is a chronic inflammatory diseaseaffecting articular greater extent men than women. Most often the disease begins between 15 and 30 years of age. However, given the slow developing symptoms can often be diagnosed later.While early diagnosis (as with most other diseases) helps reduce the consequences and improve the course of disease.

In principle, the disease manifests solidification joint in which there is a substitution of soft and elastic tissue (tissue, cartilage) tissue rigid – bone.

 

Risk factors Bechterew’s disease

Cause of developing the disease are not yet fully known. Certain contribution to the development of the disease’s inheritance.(90% of patients have their cells labeled antigen HLA-B27).However, this “word” on the cell, the immune system can be read as “the body’s own cells – not to attack!”, They are evidence of a situation where a person has a cell antigen HLA-B27 and ankylosing spondylitis ill. So there must be some triggering mechanism to ensure that the immune system began writing on the cell HLA-B27 taken as a call for the destruction of cells. This is probably attack bacterial organism that bears on the surface of antigen similar HLA-B27. Against such bacteria attacks the immune system properly.And when this attack begins “inadvertently” destroy its own cells. Stop reading the inscription HLA-B27 as “the body’s own” but as “bacteria-like, rather destroy it!”

Risk factors for the disease are heredity, therefore, in conjunction with external factors (probably infections).

 

Prevention of Bechterew’s disease

Ankylosing spondylitis can not currently be prevented. Can kicks diagnose and mitigate irreversible joint damage that causes.

 

Signs and symptoms of Bechterew’s disease

The first symptoms is usually pain in the hip-Crisis (area under the shoulders, spinal fusion with pelvic girdle). Patients wake up (often already in the second half of the night) with a feeling of painful stiffness. This stiffness usually rozcvičí. Escalating painful symptoms tend to be over weeks, months turn into relief – but only temporarily. The course of disease onset time (alternation of painful and painless period) also contributes to the fact that the patient with difficulty doctor visits later.

Since Ankylosing spondylitis inherently inflammation manifested and systemic inflammation, like e.g. influenza (fatigue, temperature, pain ..)

Inflammation, along with the pain may spread throughout the body. And eventually it may affectlarge joints (knee, hip), spine, small peripheral joints (knuckles), often solidification originally cartilage connecting the ribs to the sternum, which prevents deep breathing (chest pain when breathing often leads to misdiagnosis – failure of the heart or lungs).

Nejpozorovanějším disabilities, however, is the solidification of the spine, which usually leads to bend her patients and then walk hunched and bent over.

 

Treatment of Bechterew’s disease

The disease is currently not completely cured. The changes caused by the disease is irreversible, but other degenerative changes can at least slow, at best avoided.

The main focus of treatment is regular exercise therapy, which focuses primarily on strengthening abdominal and back muscles (which have a major impact on the spine), spinal mobility developing and practicing proper breathing.

Treatment of Bechterew’s disease also focuses on relieving pain, the patients largely suffers, and to counteract the inflammatory process. Usually administered NSAIDs (Ibuprofen). When the peripheral form of the disease (disability small joints) are served e.g. methotrexate to suppress the inappropriate immune response.

From a modern treatment for ankylosing spondylitis applied so. biological therapy, a therapy which specifically affects immune response (which in the case of Bechterew’s disease disproportionate and wrong). Biological therapy that inhibits inflammation worded response. We are currently two types of preparations (based on active substance, etanercept and infliximab).

Biological therapy has many benefits – act quickly (within days), intervention is targeted and effect demonstrated (stopping disease progression) – but a big disadvantage of limited availability. In the Czech Republic there is a database of patients asking for biological treatment.

The more advanced (but accessible) treatment include cryotherapy, or cold therapy. Therapeutic treatment involves several visits to the freezing chamber (with a temperature of -60 to -180 ° C).This therapy has many positive effects on the body of the patient – among the most prominent reduction of pain, suppress the inflammatory response leads to an increase in the mobility of the affected joints, after the “shock freeze” relaxes the contracted vessels, will relax the muscles, increase in overall performance.

Also in ankylosing spondylitis recommended treatment is called. shockwave. On the affected area shall be accompanied by a special generator head high pressure (5-6 bar) pulses. These pulses (short and intense) erodes and dissolves calcium deposits in soft tissues (which cause degenerative their rigidity). The result is reduced stress and improved blood circulation in the affected areas. Also important to alleviate pain.

 

How can I help myself

It is important that the patient – bechtěreviků – responsibly respected the prescribed exercises.
It is also beneficial movement in the water, various massages. Patients should be advised what medications are appropriate for pain, what combination of drugs contrary, not to use.

To increase the comfort of everyday life is good for the patient to choose a quality mattress on which to best sleep. Furthermore, in the more advanced ossification of the spine where movement sit down and lifting from sitting to standing is difficult, patients appreciate extra chair attachment to the toilet bowl ..

Finally, the patient should avoid sedentary job, as long sitting without moving logically contributes to the solidification of the body and worsening signs of Bechterew’s disease.

 

Complications of Bechterew’s disease

The main complications of the disease include the development of inflammation in various organs (often associated with heart disease, lung, kidney, conjunctivitis, tendons ..).

The patients at risk of accidents, which is inflexible backbone more susceptible. A spinal injuries may end in paralysis or even death.

Less dangerous, but common complications are the side effects of pain medication (their symptoms may be eg. The development of gastric or duodenal ulcer)

Other names: ankylosing spondylitis, Bechterew, Bechterew’s disease, ankylosing spondylitis, morbus Bechterevi

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