Current recommended advice guidelines for rheumatologists is:

"In adults with active AS, strongly recommended continuous treatment with NSAIDs over no treament with NSAIDs"

Same guidelines make no mention of advising patient of potential links with diet or intestinal permeability. Which is although disappointing, I understand the reasoning, still not enough empirical evidence/research, and very tricky for a doc to try and prescribe diet in todays pill popping world.

So as a newly diagnosed AS patient, this puts me in a conundrum. There is evidence that NSAIDs do appear to slow the progression of AS, particularly in early stages, However, NSAIDs also cause damage to the gut lining, leading to increased Intestinal Permability. A theory exists that IP/Leaky is one of the underlying causes for AS, or at least it is the bottleneck that can be potentially fixed through a gut-based treatment approach.

So, go against doctors advice to not take NSAIDs (as they damage the gut, and want to take the unrecommended gut based approach) Vs taking the NSAIDs (which may slow progression, but in my eyes do not target the actual underlying problem. I am currently skipping the NSAIDs, but would be interested to hear some constructive discussion around this topic.

Sources:

Current Guidelines: http://www.rheumatology.org/Portals/0/Fi...Spondylitis.pdf

NSAIDs slow progression of AS:
http://www.medscape.com/viewarticle/771061