As support for holistic disease management continues to grow, the topic of diet for Axial Spondyloarthritis remains as confusing as ever. 

The standard two-prong approach of most doctors is medication and movement, with diet rarely rating a mention.

This is in spite of the growing body of evidence that our gut and digestion (and therefore our diet) has a crucial role to play in all inflammatory disease. 

Medical Management of AS

 Conventional medicine focusses on managing symptoms in the here and now, not analysing what went wrong in the first place. 

If your doctor is monitoring you for physical changes indicating progression, promoting medication and recommending daily movement, they are doing what’s required of them. This is current best practice in the medical management of Axial Spondyloarthritis. 

A diagnosis of AS involves little focus on root cause analysis or lifestyle factors that may have predisposed someone to entering a state of disease. It’s an approach which avoids blaming patients for their ill health (and rightly so) but it misses vital insights into what can support recovery. 

The disconnect between diet and disease

In spite of mounting evidence connecting gut health with disease, diet remains a grey area doctors aren’t willing to touch. There is no universally agreed upon diet for AS* and no large-scale studies are underway to change that anytime soon. 

Unfortunately, research into the gut and microbiome doesn’t directly translate into dietary recommendations. Meanwhile most government-funded health messages still trot out the outdated ‘healthy food pyramid’ with its skew towards large-scale agricultural interests.  

It’s a known fact medical training pays only passing interest to nutrition and food’s impact on the body. Furthermore, Western medicine has traditionally viewed body systems as separate entities rather than an interconnected whole. 

Little wonder most rheumatologists won’t relate what’s happening in your digestive tract with the inflammation in your joints, muscles and bones. Science exists that clearly shows the connection, but medicine is a highly conservative field and the response to change takes time.

The importance of an integrated approach

In spite of all this, the anecdotal evidence supports what research is telling us. Chronic illness and inflammation begin in the gut, and the health of the gut is determined by what’s on your fork. 

Ignoring diet as a key component of your self-management plan is missing out on a powerful lever you can use to bring yourself relief. 

There’s a variety of different diets that appear to be effective in reducing the symptoms and disease activity of AS, but they all have a few features in common;  removing processed foods, feeding the microbiome, reducing sources of inflammation and returning to traditional preparation methods.  Remove irritants, heal the gut and inflammation starts to subside. 

Time Pressure

People in pain want results. Most patients sitting before a doctor want relief quickly; a result usually only possible with medication. 

We live in a fast-paced world where people are used to instant gratification. Addressing lifestyle change takes time and effort many people are not willing to sacrifice.

These demands are reflected in the type of service modern healthcare provides, even though there is often no effective quick-fix where chronic illness is concerned. 

The average length of a medical appointment is 10-15 minutes. Performing examinations, explaining medication or procedures, writing out prescriptions or referrals and answering questions can easily consume this time without leaving room for further discussion. It’s easy to see how lifestyle change doesn’t factor in. 

Empower yourself to make change

Your doctor’s role doesn’t extend to researching dietary protocols, writing meal plans or monitoring your weekly shop. Lifestyle change happens in the habits and choices that make up every day life. 

There might be no obvious or immediate impact.  While small changes adding up overtime can indeed be powerful, they’re difficult to observe or measure. 

This is where your doctor’s job leaves off and yours begins. And until the time when science can deliver an optimum diet for Axial Spondyloarthritis, included in your job description is seeking out those answers and embarking on a process of trial and error. 

If you’re not sure where to start, a wealth of inspiration and ideas can be found in the experience of others. Check out these success stories featuring people just like you who once struggled with the pain and misery of AS. Luke’s Story, Janneke’s Story, My Story

And remember, you don’t have to navigate the complexities of managing Axial Spondyloarthritis on your own. As a specialised health coach, I offer tailored support and guidance grounded in more than 20 years experience of AS. Together we can uncover effective lifestyle strategies to improve your well-being and enhance your quality of life. Reach out via my email and we can start the journey towards better health together.

*The London AS Diet is one possible exception, although it is not on the radar of most medical practitioners. Read more about the No Starch Diet here