Italian version

What is rheumatoid arthritis? What are its symptoms?

Rheumatoid arthritis (AR) is a chronic inflammatory systemic disease whose causes are still unclear.  In around 2/3 cases the beginning of the disease is slow and insidious and its symptoms such as weakness, fever and weight loss can precede the joint pain, even for a long period.  Pain in the joints, most of all in the hands, fingers and wrists is symmetric; the rigidness and obstruction of these joints upon waking is constant and usually passes after an hour.  These symptoms are usually followed by swelling, heat and sometimes redness.  What's more, especially in cases that have not been treated in an appropriate manner, the disease may also affect other districts and organs, such as the heart, lungs, peripheral nervous system and the eyes.

How can AR be diagnosed?

At least 4 of the following criteria must be present:

• Morning stiffness
• Arthritis in 3 or more joints
• Arthritis in the hand joints
• Symmetrical arthritis
• Rheumatoid nodules (subcutaneous nodules located near the bone protrusions)
• Rheumatoid factor (pathologic levels in the blood)
• Alterations in x-rays

Once the diagnosis has been made, how can AR be cured?

The objectives of AR therapy are:

• Reduction of pain
• Reduction of inflammation
• Protection of the joint structures
• Preservation of the functional capabilities
• Restriction of the systemic diffusion of the disease.

Since its precise causes are still unknown, and the action mechanism of most of the drugs used to cure it is unclear, the therapy is for the most part empirical; the therapy does not cure the disease and all of these treatments only serve to alleviate the symptoms of the disease. The various therapies that are used (anti-inflammatory drugs, cortisone, methotrexate, organic drugs, immunosuppressants), are geared towards a non-specific suppression of the inflammatory process, in the hope of mitigating the symptoms and preventing the development of progressive damage to the joints.

What are the new therapy strategies?

There has been a fairly recent discovery of substances called adipochne; these substances are produced within the body's fatty tissue and their role in inflammatory processes, in AR and the immune system has been clearly demonstrated. In view of these observations, we can imagine what can be done to reduce joint inflammation, identifying those foods that, by causing delayed food allergies, contribute to maintaining and exasperating joint inflammation. In short, an approach that doesn't only consider drugs, but also pays particular attention to our eating habits must be thought of as a new therapeutic frontier in the cure of diseases.

People who seek help for various forms of arthritis are visited by me or by Dr. Speciani. If necessary, we complete the diagnostic procedure but in most cases, the patient has already gone through an infinite number of examinations and doesn't need further clinical testing except for a nutritional evaluation that is performed by way of an ALCAT test (for patients who have already started a remote, online-assisted diet program) or a DRIA test that can be done during the clinical visit. The doctor and the nutritionist draw up a dietary regime and prescribe the therapy based on the diagnostic evaluation. The fundamental aspect of this type of approach is that, in view of the results achieved, for the first time the  patient feels that he is doing something for himself without depending on drugs, and this often aids in the healing process and provides for a positive outlook with regard to thedisease.

Professor Marco Froldi
Allergist, Immunologist, Internist

Italian version