Rheumatology International

, Volume 29, Issue 7, pp 755–758 | Cite as

Association of macroscopic gut inflammation with disease activity, functional status and quality of life in ankylosing spondylitis

  • Gulen Hascelik
  • Bengi OzEmail author
  • Nese Olmez
  • Asuman Memis
  • Gazi Yoruk
  • Belkıs Unsal
  • Nese Ekinci
Original Article


The aim of this cross-sectional study was to evaluate the frequency of intestinal inflammation and its association with disease activity, functional status and quality of life in patients with ankylosing spondylitis (AS). A total of 25 patients with AS had undergone ileocolonoscopy and concomitant histological study. Clinical and demographical parameters, BASDAI, BASFI, and SF-36 scores were compared between patients with and without macroscopic gut inflammation (MGI). Colonoscopic study revealed MGI in 9 patients and macroscopically normal gut mucosa in 16 patients. On histological examination, of 25 patients 20 had gut inflammation, mostly in ileum. BASDAI score was higher (P < 0.05), SF-36 pain and physical scores, and chest expansion measurement were lower (P = 0.00, P = 0.01, P = 0.01), duration of morning stiffness was longer (P = 0.01) in patients with MGI. Serum C-reactive protein, erytrocyte sedimentation rate levels were similar between groups (P > 0.05). There is high prevalence of histological gut inflammation in AS patients. More active disease should suggest gut inflammation in AS patients.


Ankylosing spondylitis Disease activity Gut inflammation 


  1. 1.
    Rudwaleit M, Baeten D (2006) Anklosing spondilitis and bowel disease. Best Pract Res Clin Rheumatol 20:451–471. doi: 10.1016/j.berh.2006.03.010 PubMedCrossRefGoogle Scholar
  2. 2.
    Sieper J, Braun J, Rudwaleit M et al (2002) Anklosing spondilitis:an overwiew. Ann Rheum Dis 61(Suppl 3):1–8. doi: 10.1136/ard.61.1.1 Google Scholar
  3. 3.
    Mielants H, Veys EM, Cuvelier C, De Vos M (1996) Course of gut inflammation in spondylarthropathies and therapeutic consequences. Baillieres Clin Rheumatol 10:147–164. doi: 10.1016/S0950-3579(96)80010-0 PubMedCrossRefGoogle Scholar
  4. 4.
    Lee YH, Ji JD, Kim JS et al (1997) Ileocolonoscopic and histologic studies of Korean patients with ankylosing spondylitis. Scand J Rheumatol 26:473–476PubMedCrossRefGoogle Scholar
  5. 5.
    De Keyser F, Elewaut D, De Vos M et al (1998) Bowel inflammation and the spondyloarthropathies. Rheum Dis Clin North Am 24:785–813. doi: 10.1016/S0889-857X(05)70042-9 PubMedCrossRefGoogle Scholar
  6. 6.
    Mielants H, Veys EM, Cuvelier C, De Vos M (1988) Iliocolonoscopic findings in seronegative spondylarthropathies. Br J Rheumatol 27:95–105. doi: 10.1093/rheumatology/27.2.163-b PubMedCrossRefGoogle Scholar
  7. 7.
    Mielants H, De Vos M, Cuvelier C, Veys EM (1996) The role of gut inflammation in the pathogenesis of spondyloarthropathies. Acta Clin Belg 51:340–349PubMedGoogle Scholar
  8. 8.
    Van der Linden S, Valkenburg HA, Cats A (1984) Evaluation of diagnostic criteria for ankylosing spondylitis. A proposal for modification of the New York criteria. Arthritis Rheum 27:361–368. doi: 10.1002/art.1780270401 PubMedCrossRefGoogle Scholar
  9. 9.
    Haywood KL, Garratt AM, Daves PT (2005) Patient-assessed health in anklosing spondylitis:a structured review. Rheumatology (Oxford) 44:577–586. doi: 10.1093/rheumatology/keh549 CrossRefGoogle Scholar
  10. 10.
    Calin A, Garrett S, Whitelock H et al (1994) A new approach to defining functional ability in anklosing spondylitis: the development of the bath anklosing spondilitis functional index. J Rheumatol 21:2281–2285PubMedGoogle Scholar
  11. 11.
    De Vos M, Mielants H, Cuvelier C et al (1996) Long-term evaluation of gut inflammation in patients with spondyloarthropathy. Gastroenterologhy 110:1696–1703. doi: 10.1053/gast.1996.v110.pm8964393 CrossRefGoogle Scholar
  12. 12.
    Mielants H, Veys EM, Cuvelier C et al (1995) The evolution of spondyloarthropathies in relation to gut histology. Part II: histological aspects. J Rheumatol 22:2273–2278PubMedGoogle Scholar
  13. 13.
    Cuvelier C, Barbatis C, Mielants H et al (1987) Histopathology of intestinal inflammation related to reactive arthritis. Gut 28:394–401. doi: 10.1136/gut.28.4.394 PubMedCrossRefGoogle Scholar
  14. 14.
    Falkenbach A, Franke A, van der Linden S (2003) Factors associated with body function and disability in patients with ankylosing spondylitis: a cross-sectional study. J Rheumatol 30:2186–2192PubMedGoogle Scholar
  15. 15.
    Baeton D, De Keyser F, Mielants H et al (2002) Anklosing spondilitis and bowel disease. Best Pract Res Clin Rheumatol 16:537–549. doi: 10.1053/berh.2002.0249 CrossRefGoogle Scholar
  16. 16.
    Mielants H, Veys EM, Goethals K et al (1991) Gut inflammation in the spondyloarthropathies:clinical, radiological, biologic and genetic features in relation to the type of histology. A prospective study. J Rheumatol 18(10):1542–1551PubMedGoogle Scholar
  17. 17.
    De Vos M, Cuvelier C, Mielants H et al (1990) Iliocolonoscopy in seronegative spondylarthropathy. Gastroenterology 98(4):1105–1106Google Scholar
  18. 18.
    Mielant H, Veys EM (1996) Significance of intestinal inflammation in the pathogenesis of spondyloarthropathies. Verh K Acad Geneeskd Belg 58(2):93–116Google Scholar
  19. 19.
    Smale S, Natt RS, Orchard TR, Russell AS, Bjarnason I (2001) Inflammatory bowel disease and spondylarthropathy. Arthritis Rheum 44:2728–2736. doi:10.1002/1529-0131(200112)44:12<2728::AID-ART459>3.0.CO;2-8PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2008

Authors and Affiliations

  • Gulen Hascelik
    • 1
  • Bengi Oz
    • 1
    Email author
  • Nese Olmez
    • 1
  • Asuman Memis
    • 1
  • Gazi Yoruk
    • 1
  • Belkıs Unsal
    • 1
  • Nese Ekinci
    • 1
  1. 1.Ataturk Training and Research HospitalIzmirTurkey

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