A pig, a cow, and a crab, all common food allergies that can affect axial spondyloarthritis, look menacingly as flames grow around them.

Food Allergies, Gut Inflammation, And AxSpA

There is not yet any concrete evidence showing how food allergies affect inflammation in axial spondyloarthritis (AxSpA). However, we do know that when a food allergy triggers the immune system, it is possible for inflammation to reach the joints.

This occurs because food allergies can disrupt the barrier of the intestine and allow toxins to escape to parts of the body, including joints. This disruption also causes inflammatory bowel disease (IBD), which is connected to AxSpA.

We also know that people with all types of SpA have different populations of healthy bacteria in the gastrointestinal tract, also called the gut. And this is related to the progression of AxSpA to ankylosing spondyloarthritis (AS).

How are food allergies related to inflammation?

Food allergies happen when your immune system mistakenly thinks something you eat is harmful. Immune cells then act as “first responders.” They produce a label that binds to the food and notifies the immune system that a substance needs to be destroyed. Think of this like a first responder using a siren to activate an emergency response.

These immune cells produce a protein called an antibody. This then attaches specifically to the particular food protein, which is called an antigen. This sets off a chain reaction, releasing inflammatory chemicals and causing allergy symptoms. Once these antibodies have been produced, the body instantly recognizes the food next time and the cycle starts again.1

The gut is directly exposed to food, and allergens are first identified by the gut’s immune system. As a result, food allergy is a major cause of inflammation in the gut, which is associated with IBD.2,3 This is more likely to occur if the gut has altered populations of healthy bacteria. The gut contains thousands of different strains of bacteria that maintain immune health and metabolism. When the strains of bacteria become imbalanced, it can affect your AxSpA. This puts people with AxSpA at greater risk for gut inflammation.4,5

Chronic gut inflammation can lead to disruption of the intestinal barrier. This allows inflammatory chemical signals to circulate in the body and reach joints. This could trigger inflammation in the sacroiliac joints, which are the joints most affected in AxSpA.5,6

How are food allergies specifically related to AxSpA?

There is not much direct evidence that food allergy is related to the severity of AxSpA. However, some studies have found connections.

One study showed that people with AS have higher levels of antibodies to beef, crab, and pork in their blood. This means that proteins in these foods may be triggering a larger immune response for people with AS. However, we cannot yet assume that allergy to these foods affects development of AS.7

In addition, there is a major connection between AxSpA and gut health. About 5-10% of people with SpA develop IBD, while up to 30% of people with IBD develop inflammatory arthritis. Almost 50% of people with AxSpA have gut inflammation.8 In many cases, this is a risk factor AxSpA to progress to AS. Meanwhile, reduction of AxSpA symptoms is associated with proper gut health.9

Finally, many studies have shown that SpA severity is linked to altered gut bacteria environments. Because this can lead to an abnormal immune response, food allergies may cause increased inflammation for people with AxSpA.

Overall, these studies show that increased gut inflammation, which is caused by food allergies among many other factors, contributes to the progression of AxSpA.

What types of foods are most linked to inflammation?

There is no set list of food allergies that cause increased inflammation for people with AxSpA. Doctors in general suggest maintaining a healthy body weight and a balanced diet. In addition, some suggest an anti-inflammatory diet of foods that may reduce joint pain. This diet minimizes fried and processed foods, simple carbohydrates, dairy products, and alcohol and tobacco.10 On the other hand, the diet is rich in vegetables, fruits, cereals, beans, and fish.

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