Ellen Kamhi, PhD, RN, presents a case study of a 45 year old male with severe ankylosing spondylitis.

by Ellen Kamhi, PhD, RN

Gerald, 45, was so severely affected by ankylosing spondylitis when he first came in for an evaluation, that he was virtually wheelchair-bound. He walked, with great difficulty, with the assistance of two crutches. He also had severe fibromyalgia , chronic fatigue, and insomnia. He had spent many years trying to find help for his ailments, but had found no relief.

Gerald’s health problems had started when he was a child. His diet was poor—lots of starches, meat, and sweets, very few fruits and vegetables—and he was constantly fatigued, had little energy, and complained of muscle pain. He received myriad doses of antibiotics for various ailments throughout his childhood. In his twenties, he began to notice stiffness in his lower back in addition to body-wide pain and inflammation. His diet was still poor at this time, consisting of large quantities of cola and chocolate (to artificially boost his energy levels), hamburgers, fast foods, and very few vegetables.

One morning, shortly after a severe bout of the flu, Gerald found he could not get out of bed because the stiffness and pain in his joints and muscles were so severe. He was 28 years old. As he continued to try to function, Gerald had to get up earlier every morning, spending several hours to stretch and limber up his body enough to get to work.

Gerald consulted his family physician and specialists in rheumatology, but they were unable to provide a definitive diagnosis of his problem. He was given nonsteroidal, anti-inflammatory drugs (NSAIDs) to suppress the pain and sent home. He was even referred to a psychiatrist for his condition. Over the next several years, his health continued to decline. The stiffness and pain were made worse by inactivity and rest, which prevented him from sleeping more than two to three hours at a time. His hands and feet would stiffen up if he didn’t continuously flex them and his back, shoulders, and muscles were so tight that he felt as if he was in “a cement suit.” Simple tasks like shaving, bathing, and getting dressed became extremely difficult.

At age 39, Gerald was put on permanent disability leave from his job. He sought help from a string of rheumatologists and pain clinics. His condition was finally diagnosed as ankylosing spondylitis and fibromyalgia, but the therapies they offered—NSAIDs, psychotherapy, and exhausting physical therapy—provided no relief. It was in this state that Gerald came to the clinic.


Diet- Mostly vegetarian, whole foods diet emphasizing fruits and vegetables, raw seeds and nuts, and whole grains. Gerald took vegetarian cooking classes and learned about juicing in order to help him with this transition. Almost immediately he noticed a difference—less fatigue, more joint flexibility, and better sleep patterns.

Stool analysis, blood tests, and food allergy tests were conducted to get a better picture of his condition. He was in an extreme state of dysbiosis, with tests indicating the absence of the friendly bacterial species Lactobacillus and Bifidobacteria in his intestinal tract. Two varieties of pathogenic bacteria, Klebsiella and Streptococcus, and a severe overgrowth of the yeast Candida albicans, were discovered. Klebsiella is a factor in some ankylosing spondylitis cases because it is able to escape detection in the body due to a unique genetic marker. Gerald also had allergies to a large number of foods, including bananas, beans, chicken and turkey, clams, cheese and dairy products, eggs, oats and rye, salmon, wheat, and yeast (brewer’s and baker’s).

We started Gerald on a series of ten colonic irrigation treatments with Biocidin, an herbal antimicrobial formula, for the bacterial and yeast infections. He also received four additional (non-Biocidin) colonics containing probiotics to help repopulate his intestines with friendly bacteria. This therapy had a dramatic impact on Gerald: he had more energy, his inflammation virtually disappeared after each treatment, and he even lost weight. We also gave him Streptococcinum nosode , a homeopathic preparation, to decrease the abnormally high numbers of antibodies to this bacteria in his body.

To address his multiple underlying imbalances, Gerald began taking a number of remedies:

-To combat the Klebsiella bacteria and yeast infection, we recommended berberis and grapefruit seed extract, both powerful antimicrobials.

-To improve his digestion, we recommended a digestive enzyme supplement. This helped with Gerald’s bacterial and yeast infections, because improving digestion in the upper part of the digestive tract will “starve” the pathogenic organisms in the bowel. Enzymes taken between meals also help dissolve circulating immune complexes, a factor in causing inflammation in the muscles and joints.

-For the chronic pain and inflammation, we gave the enzyme bromelain (from organic pineapples) along with curcumin, both having excellent anti-inflammatory properties. We recommended Licorice Root Solid Extract as a tonic for his stressed adrenal glands, and valerian root and white willow bark one hour prior to bedtime. We also gave him Rhus Tox 60C, a homeopathic remedy specifically for muscular and rheumatic pain and stiffness that is made worse by inactivity.

-Gerald also took a fish oil supplement, containing the omega-3 essential fatty acids EPA and DHA.

-To support his liver as it processed the toxins out of his body, Gerald also took the herb milk thistle.

In just two months on this therapy regimen along with the dietary changes and colonics, Gerald made significant progress, moving from being 15% functional to 50% functional. A subsequent stool analysis showed that the Klebsiella had been eradicated and the friendly bacterial microflora were re-established. Gerald received regular massage therapy and chiropractic treatments to help with the pain and stiffness. He fasted on vegetable juice for seven days, which put an end to his pain. After the fast, he started incorporating “green” foods, such as spirulina and blue-green algae, into his diet. Green foods are important for detoxification and they helped improve Gerald’s energy levels and sleep. Gerald also sought counseling to help with the emotional components of his arthritis.

Since he embraced this holistic approach eight years ago, Gerald continues to improve. He shows no signs of ankylosing spondylitis through subjective and objective measurements and feels that he is almost completely functional again. He can now go out and engage in physical activities without having to endure days of pain and inflammation afterwards.

Copyright © Ellen Kamhi, PhD, RN