Low gluten starch diet and nutritional supplementation in two cases of ankylosing spondylitis

Ankylosing spondylitis (AS) is a rheumatic disease, inflammatory and progressive, associated with HLAB27 antigen and inflammatory bowel disease (5-10%); such as Crohn's or ulcerative colitis and a higher percentage of cases with AD, are associated with subclinical intestinal inflammations. It is also associated with intestinal permeability and bacterial translocation with fecal presence of Klebsiella pneumoniae. Celiac disease (CD) and non-celiac gluten sensitivity (SGNC) is strongly related to autoimmune diseases. Several studies support the improvement of AD symptomatology by reducing starch in the diet and gluten. Low bone mineral density (BMD) is a common comorbidity but poorly appreciated in patients with ankylosing spondylitis (AS), with a prevalence of more than 50% in patients undergoing detection. Vitamin D, in addition to having functions in bone metabolism, has immunoregulatory functions. Nutritional supplements such as quercetin, l-glutamine, pomegranate, n-acetylcysteine, boswellia serrata, curcuma longa, probiotics have proven functions for the improvement of mucosal inflammation and improvement of intestinal permeability. Objective. To show the efficacy of a diet low in starches and gluten, supported with nutritional supplements such as orthomolecular therapy, to improve intestinal permeability and typical pains in two cases of AD Method. Two cases were chosen in which the same type of diet and vitamin D supplementation was used. But in each case there was an additional specific supplementation according to the most particular symptoms of each patient. Conclusions. The diet low in starch and gluten-free together with personalized orthomolecular therapy, can be a treatment to be taken into account in AD as a treatment to help reduce pain and the focus of inflammation, as well as improve intestinal permeability.