Hey John

Thanks for the detailed response. What you say makes sense to me but I guess my concern is that since I am new to this I keep thinking I am missing something, besides diet, that may help me. We know that NSAID's mask the pain and damage the stomach. Maybe the reason I have very little damage is b/c I rarely take them, who knows. But they do cut down on the inflammation which should in theory help with damage. Is it your belief that after the gut is damaged from NSAID use to the point that you cannot take NSAID's anymore does the disease then kick in harder or do you believe that all the while you are taking NSAID's the damage is still progressing? I think I read the TNF study you refer to and the disappointing news was that radiographic progression of AS was not slowed any better by the TNF's then by NSAID's. I think it all means that a multi disciplinary approach is necessary to treat this disease with diet being paramount but I also think genetics have to have some role in this. If they did not everyone would have severe AS and that just is not the case. I am sure there are lots of folks out there with mild AS who maybe dont follow the diet but do ok on damage. Can I prove that, no, but it stands to reason that there are folks out there like that and that says that there are other things at work in how this disease progresses. I am young and fairly un-damaged and want to keep it that way. I am not really challenging the current NSD wisdom as much as trying to get a handle on what works and what does not. For me it seems exercise is huge, diet is important but a lot of starch's dont seem to affect me negatively. I spend most of my days is the 0-1 pain level and so I have a hard time judging if eating/not eating starches is doing anything. I may have to use blood work (ESR) to determine if the diet has an effect. For now I will continue as I had before I found out I had AS. Good, hard exercise, sensible diet that was already fairly low in starch and I will keep an eye out for anything that changes. Also I guess I am pre-AS as my SIJ's are not fused, inflamed for 10 years yes, but not fused.

Thanks

Chris