Aim: We all know the different dietary interactions of rheumatological diseases, but we wanted to determine what their effects on patient follow-ups and treatment protocols will be in long-term follow-ups. Introduction: The importance of diet in many different diseases is known and new effects are added every day. Developed societies, although having successfully reduced the burden of infectious disease, constitute an environment where metabolic, cardiovascular, and autoimmune diseases thrive. Patients that have chronic fatigue, joint pain (seasonal variability) and resistant dyspepsia symptoms have food intolerance depended auto immune disease.(FIDAD) Weight loss is frequently offered as a therapy and is aimed at improving some of the components of the metabolic syndrome. Among various diets, ketogenic diets, which are very low in carbohydrates and usually high in fats and/or proteins, have gained in popularity.Similar studies reveal a serious problem of dietary influence, shows that it can.73 of our patients were followed up for sixth years. The patients were evaluated according to their previous and subsequent symptom severity, drug use, and examination results. Material and Method: We included five disease groups in the study. The number of lines followed in the sixth year increased to 73. The symptoms and examination evaluations of the patients were performed. Patients diagnosed with inflammatory bowel diseases (Crohn's disease and ulcerative colitis), multiple sclerosis, psoriatic arthritis, ankylosing spondylitis and reactive arthritis were treated and followed up according to the guidelines, while diet adjustments were made and follow-up was continued. Physical examination and aching joint examination, blood tests and stool analysis were performed every three months. In the follow-up of the patients, the standard treatment protocol was gradually reduced depending on the decrease in the symptoms according to the ACR disease and treatment evaluation criteria. Dietary adjustment was not interrupted in the patients. When an increase in disease activity was observed in reducing the treatment protocol, the previous protocol was returned. Treatment arrangements of the patients were arranged according to EULAR rheumatology criteria. No additions were made to the rheumatological treatment protocols of the patients with the tests performed. According to the results, the treatment protocols of the patients were reduced and discontinued. The follow-ups were continued and the controls were repeated with the same frequency. Patients were instructed to refer again when they felt a change in symptoms or pain.Additional infection treatments were performed in the controls (urinary tract infection, throat infection, etc.). Antibiotic therapy was given when necessary. Result: Nearly all patient treatment aim to collect information on the anniversary of them follow up at years 1 and 2 (year 1 = 40 /73 (54.7%); year 2 = 55/73 (75.3%), with half of the trials requesting intermediate follow- up data at 3 years (70/73 (95.8%). A similar pattern is present between years 3 and 5, with all trials collecting data annually (from year 5 = 70/73 (95.8%); from years 5 to 6 = 71/73 (97.2%) In this way, the rates of no treatment over the years were as observed in the patients who underwent a diet protocol. Discussion: Additional evidence is needed to suggest that diet is the trigger for this remission in patients. However, the fact that diet is a trigger and when it is removed, patients go into remission cannot be ignored. In order to establish a direct connection with these diseases, it must be shown that the defense cells that cause autoimmune disease originate from the same clone. Despite this, it is obvious that a drop of benefit is guiding in the follow-up and treatment of diseases. Although it is certain that more publications and research are needed, it should be considered to be added to medical treatment in cases where adequate treatment response is not obtained or in resistant cases.





