What To Do When Having a Flare? Stop Eating!

I am all too familiar with what you’re going through: you have Ankylosing Spondylitis and you’re in the middle of a flare.  You feel horrible.  Your spouse, significant other, friends, parents, and siblings all mean well but they can’t possible understand what you’re going through.  It’s not just the pain.  If it were only just the pain.  It’s the feeling of hopelessness.  The feeling that you can’t explain this freaking disease to anyone, can’t really truthfully tell a friend or your spouse what it’s like to feel 90 years old in your 20 or 30 or 40 year old body.  You can’t possible explain that realization you have one morning while trying to figure out a relatively painless way to simply roll out of bed that this may be as good as you ever feel.  My doctor told me on day one of my ankylosing spondylitis diagnosis that this was, “…a disease you’ll die with, not from.”  I get it.  All of it.  I’ve been there.  Even recently.

Yes, I’ve had flares recently.  Want to know why?  Because I’ve grown so confident and healthy on the No Starch Diet that I’ve started to incorporate “cheat days” into my diet.  I had a cheeseburger recently for the first time in years.  Years.  It was good.  But honestly, not worth the flare.  Then I had pizza.  Awful.  I do not miss pizza in the least.  Right after eating the pizza I had a flare.

Why in the world would I play with fire like this?  I’ll tell you: because I’ve discovered the best way to quickly get over a flare.  Fasting.

I hesitate to write this post because I think there is the possibility that it will cause some serious confusion.  On the one hand, I say that you should embrace the no starch diet 100% in order to treat your AS.  And on the other hand, here I am confessing to you that I have incorporated “occasional” cheat days into my diet.  But it’s the truth.

Here’s what I think has happened.  I think I’ve been on the strict 100% no starch diet for so many years that my body has likely “normalized” on several levels.  I think my gut bacteria (likely the dreaded Klebsiella, but maybe others too) have returned to “normal” levels or maybe even extremely low levels, and that this allows me to incorporate the occasional cheat day into my diet.  Yes, yes, I realize that sounded completely unscientific and some of you may be rolling your eyes right now.  Whatever.  I’ve been on this diet for so long and I see such a direct cause-effect relationship between ingested starch and horrible flare pain that I feel I’ve earned a bit of unscientific personal speculation.

All I know is that my body can now tolerate the occasional cheat day.  What do I mean by occasional?  Maybe once a month.  And only certain foods.  Rice?  Not once.  It kills me every time.  Hummas?  God no.  But I can handle a cheeseburger with the bun.  Even sweet potatoes.  But just once in a while, and only because I’m confident that I can stop the flare in its tracks if it happens.

How do I stop my flares?

I stop eating for at least 24 hours.  No food, just water for 24 hours.  Fasting in this manner stops the flare in its tracks.

I also incorporate fasting into my weekly routine.  For about the last two years I’ve been trying to do a dinner to dinner fast once a week.  Thursday is my fast day so that means I eat dinner on Wednesday night and then stop eating until dinner on Thursday night.  That’s a quick and easy 24 hour fast.  I do this whether I’m flaring or not.

I’ve recently started doing twice weekly dinner to dinner fasts.  Mondays and Thursdays are my fast days.  Same deal: I eat dinner on Sunday night then no food again til dinner on Monday night.  Dinner on Wednesday night and no food til dinner on Thursday night.  I truly believe that this fasting schedule helps with my AS and is also excellent for my overall health.

But don’t take my word for it, take a look at this fantastic documentary called Eat, Fast, and Live Longer.  This is not AS specific, rather it goes into the general health benefits of a twice weekly fasting schedule.  Here’s the link to the book by the filmmaker.  A good read and I’d recommend buying it:The Fast Diet.

Eat, Fast and Live Longer – Horizon from Steve Hartman on Vimeo.



  • AMR

    Thanks so much for this article Bob. I am feeling pretty lost today – I’ve had great success recently cutting out starch (even managed to go off all medication for about a month, much to my delight) but the last few days I’ve started to flare up, culminating today in the old painful misery I know so well. I’ve been careful about what I eat but ate out two days in a row this week and think there must have been hidden ingredients in the seemingly safe food. It’s also been a stressful time personally and I have always felt this has an affect on my symptoms. I’ve come back here to your blog looking for advice and came straight across this article – tomorrow I will give fasting a go and see what happens. I already feel less upset and hopeless – thanks so much for sharing your ideas and experience, I appreciate it immensely.

    • Hi AMR,
      Let me know how things went with the fasting. I was just saying to another commenter that I use fasting as my go-to remedy to recover from a flare. Did you try it? Was it successful?

  • Nohci

    Im 38 years old female im sick since 3years
    Rice wheat potatoes corn grains made me ill then i discovered im suffer from s/p too
    I tried quinoa today .im in fasting however i cant go to anywhere from mybed very tried and mental fog terrible.
    In my country for heal sickness people doing water fasting for 7-10 days
    Period to period..not continuously
    10 days for big illness like cancer.. 3-4 times make 10days fast can heal cancer as i read on internet in my language
    Im feeling myself good in fasting after 5-6 days.
    1 day dont work in my opinion

  • Nohci

    Plus turmeric tea can help too much
    250 grams turmeric (powder)
    150 grams ginger powder
    1 tablespoon black pepper (powder)
    1 tablespoon hot red pepper
    Take 1 teaspoon from this mixture
    Add big glass of boiled hot water
    You can add honey or lemon juice too for hidden bitter taste
    Tried it twice daily
    What will you feel write pls amazing miracle
    Just need to continue

  • haidar husien

    Hi bob ;
    Can you provide your E-mail adress for me please .. as i am a doctor and wanna speak with you .
    Best wishes

    • Camille

      Please email me as well. Jonandcamillemedina@hotmail.com

      • use the “Contact” tab on upper right of the website. It goes to my email.

    • just send me a message via the “Contact” tab up at the top right of the screen. It will go to my email.

  • Amber

    Hi Bob,
    I have Crohn’s that manifests in many extra-intestinal symptoms such as iritis and arthritis. It started out with SI joint pain, but I’ve never been given the AS diagnosis nor have been tested for HLA-B27 though I’m wondering now if my dad also had AS since he had Ulcerative Colitis and a hunch back and arthritis. Anyways, I’m in the midst of a very long flare which has lasted over a month now, and I’ve done 2 rounds of steroids but the arthritis is still hanging on.

    Did you find you had to fast long enough for all of your symptoms to resolve before you stated eating? And did you ever try to fast while in the midst of a long flare, not just at the beginning signs of one? I did a 46 hour fast and was feeling much better in regards to arthritis, so I ate dinner last night and I lost any ground that I gained with fasting in regards to arthritis relief. I had already been following a stricter version Specific Carbohydrate Diet, and now that I’ve read about the starch connection, I’m paying more attention to starches. My flare started after I tried to add nuts back in after 2 years without eating them, and coincidentally there were high starch nuts, cashews and pecans (this was before I made any possible connection of Crohn’s to AS and starches).

    I’m not sure I have enough mental gumption at this point to do much longer of a fast, but at this point I don’t feel like I have many other options. I don’t want to lose all the ground I gain from fasting, and I’m wondering if that means I need to fast until total symptom resolution, which I’m not sure I can do at this point.