Spondyloarthritis Linked to Bad Intestinal Bacteria

Spondyloarthritis produced by bad gut bacteria.

Spondyloarthritis linked to pathogenic gut bacteria.

Spondyloarthritis – a form of arthritis – affects millions of people around the world, and rates have been rising. Research now reveals that certain types of intestinal bacteria, along with inflammatory bowel disease (IBD) are linked with spondyloarthritis.

Spondyloarthritis is a form of arthritis that primarily affects the spine, but also can affect the joints of the arms, along with nails and skin as it advances.

Spondyloarthritis typically includes ankylosing spondylitis, psoriatic arthritis, enteropathic peripheral arthritis and enteropathic axial arthritis.

For decades, as spondyloarthritis rates have been increasing (currently over 1 percent of U.S. population), conventional medicine has linked this form of arthritis to aging and genetics. No one figured on intestinal bacteria.

Previously, we reported on research finding that rheumatoid arthritis is linked to intestinal bacteria. Because spondyloarthritis and rheumatoid arthritis are two of the most prevalent forms along with osteoarthritis, this paints a brand new picture of arthritis in general.

Spondyloarthritis in French hospital research

The 2017 study comes from the Hospital of Paris in Boulogne, France, working in conjunction with the University of Versailles St. Quentin and France’s National Institute for Agricultural Research.

The study tested three groups of adult volunteers. One group was diagnosed with spondyloarthritis. The other was diagnosed with rheumatoid arthritis. The third group were healthy subjects matched for age, gender and other status with the arthritis subjects.

The researchers tested the fecal bacteria from each of the subjects. They ran RNA gene sequencing analyses on each to determine the general species makeup of the bacteria in their guts. This genetic sequencing allows scientists to pinpoint certain species of bacteria, because different species of bacteria have different DNA.

The research found that those patients with spondyloarthritis had two to three times the populations of a certain bacteria: Ruminococcus gnavus.

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The researchers also found that spondyloarthritis patients, along with the rheumatoid arthritis patients, had higher levels of inflammatory bowel disease (IBD). This is also called irritable bowel syndrome (IBS).

Ruminococcus gnavus problems

R. gnavus is implicated in other disorders, including growth impairments and other forms of intestinal disease. In a Kaiser Foundation study, for example, researchers found that R. gnavus, along with other bacteria, was associated with eczema in children.

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R. gnavus populations typically rise in conjunction with other pathogenic bacteria. These include Escherichia species (including E. coli and E. vulneris), Streptococcus sinensis, Holdemania filiformis, Gemmiger formicilis, Faecalibacterium prausnitzii and others. Proteobacteria, Clostridium and Shigella species of bacteria are often also found among these pathogenic bacteria colonies.

A 2015 study linked Faecalibacterium prausnitzii and Clostridium leptum to spondyloarthritis.

One of the reasons these pathogenic bacteria cause conditions like arthritis is because they produce toxic byproducts that are absorbed into the bloodstream. These endotoxins have shown up among joints in other arthritis studies.

There are also cases where the bacteria themselves have shown up. This has been found in some cases of prosthetic hip and joint replacements.

We’ve discussed other research showing that dybiosis with some of these bacteria are also linked to colon cancer.

Probiotics reduce R. gnavus

Overgrowth of R. gnavus is not a lost cause. Another 2017 study, this from Italy’s University of Milan, studied 20 healthy Italian adults. There were 8 men and 12 women volunteers.

Ten of the 20 were given probiotics. On a daily basis they took four billion CFUs (colony forming units) of Bifidobacterium longum and one billion CFUs of Lactobacillus rhamnosus per day, in sachets. The other ten also took sachets each day. But these didn’t contain probiotics. They were given a placebo.

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After one month, the researchers tested the subjects’ intestinal bacteria by analyzing their fecal waste. They found the daily probiotic supplement significantly reduced populations of a number of bacteria – including R. gnavus.

Other bacteria reduced by the probiotic course included some mentioned above that tend to colonize with R. gnavus in cases is dysbiosis and IBD.

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This doesn’t necessarily mean that taking probiotics will necessarily reverse spondyloarthritis. It is quite likely that the spondyloarthritis condition occurred over time as the intestinal bacteria colonies expanded in the gut.

How does a person get dysbiosis and these forms of bacteria? That’s a long story. You’d have to read my book for that.

Certainly, reducing pathogenic intestinal bacteria is a good place to start, however. Removing or at least reducing one of the likely causes could indeed help the body begin to heal itself naturally, given a responsive immune system, a good diet and botanical aids.


Breban M, Tap J, Leboime A, Said-Nahal R, Langella P, Chiocchia G, Furet JP, Sokol H. Faecal microbiota study reveals specific dysbiosis in spondyloarthritis. Ann Rheum Dis. 2017 Jun 12. pii: annrheumdis-2016-211064. doi: 10.1136/annrheumdis-2016-211064.

Toscano M, De Grandi R, Stronati L, De Vecchi E, Drago L. Effect of Lactobacillus rhamnosus HN001 and Bifidobacterium longum BB536 on the healthy gut microbiota composition at phyla and species level: A preliminary study. World J Gastroenterol. 2017 Apr 21;23(15):2696-2704. doi: 10.3748/wjg.v23.i15.2696.

Zheng H, Liang H, Wang Y, Miao M, Shi T, Yang F, Liu E, Yuan W, Ji ZS, Li DK. Altered Gut Microbiota Composition Associated with Eczema in Infants. PLoS One. 2016 Nov 3;11(11):e0166026. doi: 10.1371/journal.pone.0166026.

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Gill T, Asquith M, Rosenbaum JT, Colbert RA. The intestinal microbiome in spondyloarthritis. Curr Opin Rheumatol. 2015 Jul;27(4):319-25. doi: 10.1097/BOR.0000000000000187.

Fernández-Caso B, Domingo García D, Domingo LC, Ampuero JC. Ruminococcus gnavus infection of a metal-on-metal hip arthroplasty resembling a pseudo-tumour in a 72 year-old woman with no intestinal symptoms. Enferm Infecc Microbiol Clin. 2016 Dec 12. pii: S0213-005X(16)30343-3. doi: 10.1016/j.eimc.2016.11.002.

Arnáez Solís R, Martín Salas C, Acha Arrieta MV. Prosthetic joint infection by Ruminococcus gnavus in a patient without associated digestive disease. Med Clin (Barc). 2017 Jan 20;148(2):e7-e8. doi: 10.1016/j.medcli.2016.10.013.

Reveille JD. Epidemiology of spondyloarthritis in North America. Am J Med Sci. 2011 Apr;341(4):284-6. doi: 10.1097/MAJ.0b013e31820f8c99.

Case Adams is a California Naturopath with a PhD in Natural Health Sciences, and Board Certified Alternative Medicine Practitioner. He has authored 26 books on natural healing strategies. “My journey into writing about alternative medicine began about 9:30 one evening after I finished with a patient at the clinic I practiced at over a decade ago. I had just spent the last two hours explaining how diet, sleep and other lifestyle choices create health problems and how changes in these, along with certain herbal medicines and other natural strategies can radically yet safely turn our health around. As I drove home that night, I realized this knowledge should be available to more people. So I began writing about health with a mission to reach those who desperately need this information. The strategies in my books and articles are backed by scientific evidence along with wisdom handed down through traditional medicines for thousands of years.” Case connects with nature by surfing, hiking, running, biking and according to Dad, being a total beach bum.

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