Have you been diagnosed with Reactive Arthritis?

A number of people from the US have written to tell me they’ve been diagnosed with Reactive Arthritis, and is there a link to Ankylosing Spondylitis, because  their symptoms seem the same.  In a word:  yes.  Reactive Arthritis is a general name for various forms of arthritis which are caused by the immune system reacting to an infection or bacterium or virus elsewhere in the body.

Until recently it was usually the term used for a condition called Reiter’s Syndrome, which was characterised by (1) inflamed joints, (2) inflammation of the eyes (conjunctivitis) and (3) inflammation of the genital, urinary or gastrointestinal system.  Reactive Arthritis is now the preferred name for this condition, since the history of Dr. Hans Reiter’s dubious past of enthusiastically embracing Nazo politics and medical abominations, has come to light.

Reactive Arthritis was a term first used by the Finns in 1973-4 for arthritic symptoms which had been caused by food poisoning with dysentary from either the Shigella, Salmonella or Yersinia bacteria.  But Professor Alan Ebringer recognised that all these are close relatives of Klebsiella, although Klebsiella does not cause the symptoms of food poisoning because it is a normal bowel microbe found in most people.

However, in recent years, rheumatologists are beginning to accept that Klebsiella is commonly implicated in Ankylosing Spondylits, and the term HLA-B27 Reactive Arthritis is beginning to be used.

Anyone who has had numerous diagnoses from various rheumatologists will probably be aware that a number of different names are often given to forms of arthritis with similar symptoms.  Gradually the rheumatology world is beginning to see the wood for the trees.  Here is a statement from one authoritive source:

Reactive arthritis is considered a systemic rheumatic disease.  This means it can affect other organs than the joints, causing inflammation in tissues such as the eyes, mouth, skin, kidneys, heart and lungs.  Reactive arthritis shares many features with several other arthritic conditions, such as psoriatic arthritis, ankylosing spondylitis, and arthritis associated with Crohn’s disease and ulcerative colitis.  Each of these arthritis conditions can cause similar disease and inflammation in the spine and other joints, eyes, skin, mouth and various organs.  In view of their similarities and tendency to inflame the spine, these conditions are collectively referred to as “spondyloarthropathies”.

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How long after eating wrong food do the AS pains kick in?

Dear Bogdan Cristescu,

Your first question was how many hours after eating the wrong food will your AS pains kick in?  I think this is different  for every individual, but I hear from some of my correspondents that the pain will definitely return the day after.  With IBS pain and bloating, the pain begins to make itself felt much more quickly – about 30 minutes to an hour after eating starchy food.  If you also have IBS, you can rely on those pains to tell you you’re in for an AS flare up.  From my experience, when the IBS symptoms show, I know the AS symptoms will follow by the next day.

I’m afraid I don’t know whether hemp is starch-free or not, as I never tested it.  My advice, as always, is to get yourself some iodine and test it yourself.  Also test the protein powder, which of course should not show any signs of starch – but we can’t always rely on manufacturers to be completely upfront about these things.  Just as gluten-free foods are not usually entirely gluten-free – because the process of separating the gluten from the wheat is not perfect and depends on the efficiency of the manufacturer – so we can’t really be sure about other processed foods until we’ve tested them.  This doesn’t apply to raw foods, of course.

Now, I’m very perturbed about your fasting period when you give up meat, eggs and dairy foods.  Is this for religious reasons?  If so, you must obey your beliefs, but try to make it as short a fasting period as possible, because these are the foods you need most of all.  If you are having to give up meat, I can’t really see that protein powder is very different.  However, that is your decision.  Your food options during a fast of this sort would be very limited.  I can only think of salads including avocado, and cooked vegetables which are safe, such as spinach, asparagus, tomatoes, sweet peppers (not green) mushrooms, fennel and mild onions.  You could make some great vegetarian dishes from these, but some cheese would make a tasty addition.  Tell me what you eat in your fasting periods.  I will be very interested to hear.

Lemons are not recommended in great quantity.  The pith (white inner lining) is full of starch.  The juice is OK, but better diluted with water and of course, sugar added.  If you are experiencing a flare-up and you can trace it to any particular food, you should eliminate it, or use it sparingly.  I have never recommended raw or toasted pumpkin seeds.  I remember testing them years ago and finding them too starchy.  But once again I recommend you test them yourself.  There’s always the possibility that the samples I tested were not exactly normal: had been picked unripened, stored in cold store etc. etc.

Get yourself that bottle of iodine (original, rusty-brown in colour) and you’ll never have any worries about whether foods contains starch or not.

Feel free to write again if you wish.

Regards,

Carol

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This entry is a response to Linda Lee.

Dear Linda,

I wish I could give you another dietary plan for your flare ups, but all I can advise is to re-double your efforts with the Low-Starch Diet. I would eliminate every bit of starch from your diet for a limited time – say two weeks – or until your symptoms begin to subside. I am sure that they will, as you have already experienced when you began the diet. It is just that it’s such a shock to discover how quickly they return, that you want them to disappear equally quickly. You must have patience and the assurance that they will disappear again.

If you don’t already test for starch in your food with iodine, you must begin to do this. It reveals all the hidden starches in our processed foods. My book tells you how to do this, but you need original iodine, which is a rusty-brown colour – not colourless iodine, sometimes called povidine – which does not reveal the presence of starch. If you have trouble getting this, let me know.

Your range of problems are very serious. To have all three major diseases, AS, Crohn’s and microscopic colitis, is a terrible struggle. I really feel for you.

I am going to send your letter to Professor Alan Ebringer, who wrote the foreword in my book, because he is presently involved in research on Crohn’s. He’ll be interested to read of your case because he’s found that the Low-Starch Diet works when no other treatment does. Patients are referred to him by doctors when they are desperate because they can no longer tolerate the medication. On the Low-Starch Diet they are able to return to normal life.

I’m so sorry I can’t offer you a quick fix. But I’m sure that you will overcome your symptoms on the Low-Starch Diet – and I know of no other way.

Please feel free to write to me again if you wish.
Very best wishes,
Carol

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Do you blame yourself for your IBS?

When doctors tell you that your mysterious gut pain and bloating is all in your mind, it’s due to stress, and you just have to go away and learn to relax – do you feel guilty? Do you think, ‘The stress is my fault, I must be a very negative person,’ and get even more stressed?

When you try all those products that are advertised to overcome IBS, and they don’t work, do you think it’s your fault? ‘Obviously it works for everyone else, otherwise the manufacturers wouldn’t keep on advertising them and people wouldn’t keep on buying them!’

Let me tell you, it’s not in your mind – it’s not your fault, and you’re never going to get rid of IBS by eating more whole-grain foods, or pro-biotic yoghurts, or going on a low-fat diet, or giving up coffee and red meat – or any of the tired old recommendations.

OK – maybe for a few weeks you’ll notice a slight relief of symptoms – or a change in symptoms – but it won’t last. I know, because I tried them all for years, and they all failed.

The only thing that was successful – and still is successful after 25 years – is the low-starch diet. You see, your gut is full of bacteria, some good and some bad. The bad bacteria, klebsiella in particular, live on undigested starch in your gut. When you cut down or eliminate starch, the bacteria has nothing to live on and starves to death. And your gut pain and bloating disappears. The bacteria has been causing fermentation in your gut – and you know what happens when fermentation occurs? Gas! And gas produces pain and bloating.

There are plenty of low-starch foods to eat and cook – over 200 recipes and ideas for snacks. It’s all in my book, The IBS Low-Starch Diet by Carol Sinclair. The Low-Starch Diet works!

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IBS Low-Starch Diet now on YouTube

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How can diet reduce the pain and symptoms of arthritis?

Sounds crazy, I know. It’s easy to understand how the right diet can reduce the pain and bloating of IBS (Irritable Bowel Syndrome) because that takes place in the stomach: if you eat the wrong food, obviously your stomach is going to protest! But how could what we eat affect joint pains and backache?

I’d suffered from joint pains and stiffness for years, along with Irritable Bowel Syndrome (IBS) and I would never have believed it would be possible to eliminate the joint pains with a diet. I was always told they were growing pains, or that I’d slept in a draught, or that I had repetitive strain injury. I used to control the pain reasonably well, by having cortisone injections and pain medication. But you can’t continue having cortisone injections for the rest of your life, so I resigned myself to a certain amount of joint pain and stiffness. When it got to the stage that backache forced me out of bed in the morning, or that I couldn’t do up my bra or put my arms into a coat without help, or turn my head to look for oncoming traffic at cross-roads, I’d have another jab of cortisone. Sometimes it worked, but sometimes it made things worse.

However, the one problem in my life that I couldn’t control in any way, was cure for my IBS symptoms. I went from doctor to doctor for years, and no doctor could help me, or even tell me the cause, apart from saying it was Irritable Bowel Syndrome (IBS). It was by pure accident that I turned on TV one night and heard the words, “irritable bowel syndrome”, spoken by a white-coated doctor. I had tuned into a documentary about Addenbrook’s Hospital in Cambridge, and they were talking about their latest research, which showed that giving up all wheat based foods in your diet, would help eliminate the symptoms of IBS.

I gave up all bread, cakes, pastries, pasta from that very night, and almost miraculously, the terrible IBS pain and bloating that I’d been suffering for years – disappeared. The next day I was pain-free, and the next and the next … I could hardly believe it, but it worked! So I stayed on the wheat-free diet for about 18 months … and then the symptoms began to creep back.

But having had such dramatic relief of symptoms for the first time in my life, I knew it was something to do with what I was eating – perhaps something more than wheat? What did wheat have in common with other foods? It took me weeks, and a lot of reading up about the digestive system and what foods are made up of, and how different foods are digested, before I decided to try eliminating all foods containing starch. This meant potatoes (which I loved) rice and other starchy vegetables. The only way to be sure which foods contained starch, was to test with iodine. Simple test – you may have done it at school in basic chemistry. Just drop a little iodine on a piece of food. If the iodine drop turns from rusty-orange into dark blue/black, the food contains starch.

Within days of giving up everything that contained starch, I was back to blissful freedom from pain. Amazing to feel so “normal” – although in fact, it wasn’t normal for me – I’d couldn’t remember ever feeling this good! There was no doubt in my mind that starch was the cause of all my years of IBS gut pain, bloating and bowel problems.

As for all the back pains, neck pains, shoulder pains, elbow pains – I forgot about them, as you do when pain disappears. They’d simply faded away. I guess it had happened more slowly than the dramatic relief of IBS pain, because I don’t actually remember thinking about them at any time. I accepted the fact that my morning backache was gone and I could now do up my bra and put my arms into a coat, as just one of those things. However, I was permanently mindful of my wonderful relief of the IBS symptoms – so mindful, that I decided to write a book to tell other sufferers. The Sinclair Diet System, telling of my experience, and how to test for starch in your food was published in 1995. This was later re-printed under the title, The IBS Starch-Free Diet.

It wasn’t until 1999 when I found out that my IBS was one of the symptoms of an arthritic disease called Ankylosing Spondylitis (AS for short), that I discovered how the diet worked. AS causes inflammation and pain throughout the body – even in the gut. The AS is triggered by a bacterium called Klebsiella pneumoniae, which lives in undigested starch in the gut. We all have undigested starch in our gut – we all have lots of bacteria there – both good and bad. Klebsiella is bad. For one thing, as it thrives on the undigested starch in your gut, it causes fermentation, which causes bloating, which causes pain.

But if you also have a gene called the HLA-B27 gene in your body, you’ll get inflammation all over, because the HLA-B27 gene resembles the Klebsiella bacterium, and when the immune system tries to get rid of the Klebsiella, it mistakenly attacks the look-alike B27 genes, too.

Inflammation is a sign that the body is at war with some foreign invader. In fact, the immune system produces anti-bodies to try to destroy the invader, and in so doing, causes the inflammation. This inflammation means that the body is trying to cure itself, but the inflammation also causes pain. This is the reason for the arthritic symptoms of AS, and is what we call an autoimmune disease – when the body’s immune system turns on itself, because it can’t tell the difference between the body cells, and the invader.

If you can find out that the foreign invader is bacteria, and where it is living in the body, you have a good chance of targeting it with antibiotics – that is, if it doesn’t become resistant to them. But there’s another way of getting rid of it – eliminate the source of it’s food.

In the case of AS, it has been recognised since 1980 that the Klebsiella bacteria is strongly related to the arthritic symptoms. There’s also the possibility that other bacteria might be involved, but when tested, the majority of AS sufferers have anti-bodies to Klebsiella, so it has been concluded that this bacteria plays a major part in the disease.

Usually AS is treated by drugs, many of which have been developed to subdue the immune system and have bad side-effects. In fact, some of the most frequently prescribed new ‘miracle’ drugs – the Anti-TNF drugs, or TNF alpha-Blockers – have been given Black Box Warnings by the FDA for a number of possible dangerous complications, including TB. These side-effects are considered so serious in the US that the packs have to contain a ‘black box’ warning. (Look it up on the web). Some of the strong anti-inflammatory drugs have been withdrawn because it was discovered they caused heart problems.

The simple idea of removing the food source of the Klebsiella means that it can be controlled on a long term basis in a perfectly healthy and safe way. I’ve been on the diet for over 25 years, and apart from controlling my symptoms, I’m a lot healthier than most other people my age. I am not overweight – I don’t have diabetes – my cholesterol levels are in perfect balance – I don’t have any heart problems. I believe all this is due solely to the Low-Starch Diet.

I didn’t make the scientific discovery behind this breakthrough method of treatment – I just independently discovered the diet. The science was done by a Professor of Immunology, Professor Alan Ebringer. Professor Ebringer is a Consultant on Autoimmune Diseases to the National Institute of Health (NIH) in Washington. He’s also an Hon. Consultant in Rheumatology.

When a group of his patients contacted me via the internet to tell me that mine was the only book they could find about the problems of eating starch, how to cook low-starch meals (over 200 recipes) and live a low-starch life, they told me about the professor and their disease, AS. I was stunned. To think that someone in the medical world was actually validating my diet, was amazing. But I still didn’t know that I had the same disease – not until Professor Ebringer told me the about the arthritic symptoms, and I realised that I had had them – but they’d disappeared after I went on the Low-Starch Diet.

I have had the blood test which confirms that I am HLA-B27 positive, and Professor Ebringer has investigated my family history, which I discovered is littered with AS suffers. My father and grandmother both had the symptoms, and other living members of my family have been diagnosed with AS. All this confirms that although I’ve been on the diet for over 25 years and have no bone degeneration visible on X-rays – which are still the final diagnostic proof – I have the pre-AS condition. If I went off the diet I would develop full-blown AS.

It is such a pity that rheumatologists will not even get their AS patients to try a completely safe, drug-free method of treatment. Unfortunately they have no incentive to do so in the UK, because the NHS is so drug orientated, and medication for serious conditions is subsidised or free for patients. But in Australia and New Zealand, where patients have to pay for their medication, doctors are now beginning to recommend the Low Starch Diet.

You can try it yourself, whether you’re on medication or not. If it doesn’t work after a couple of weeks, you can just go back to your normal diet. My book, The IBS Low-Starch Diet tells you all this and much more. You can buy it from the website, www.lowstarchdiet.net, or order it from bookshops Even if you’re skeptical after reading this far, about how diet can eliminate arthritic symptoms, I urge you to get the book and give it a try. You won’t be sorry.

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Ankylosing Spondylitis

Did you know that your IBS may be connected with an arthritic condition called Ankylosing Spondylitis?

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