Archive for September, 2006
Diseases in the pancreas are uncommon and difficult to diagnose when they do occur. Infection, cancers, and wasting-away of this gland produce body difficulties such as great pain, jaundice, and intense prolonged diarrhea. The physician’s investigation alone can bring to light pancreatic difficulties, because this organ in its hidden away location, cannot be felt, examined or in any way be mechanically investigated. Complex laboratory tests must be relied upon to uncover any disease in this organ.
Diabetes Mellitus (Sugar Diabetes). Diabetes properly is a dis-
Fig. 82. The abdomen-with intestinal tract removed-reveals kidneys, pancreas and large blood vessels to the legs. The pancreas is located deep within the abdomen, and contributes greatly to the digestive process as well as producing a hormone for the body. It is essential to vigorous health, but when removed its function can be carried on artificially.
Fig. 83. Pancreatitis is an irritation of the pancreas itself. It is thought to be caused by stone formation within it, repeated bouts of alcoholism, and irritation with liver bile.
Insulin producing islets
Arterial blood supply
Fig. 84. The pancreas also produces the hormone insulin which is poured into the bloodstream. Absence of insulin means diabetes, unless it is given by hypo as a replacement.
ease of the pancreas, because its failure to manufacture the hormone insulin is directly responsible for the disease. The pancreas manufactures insulin in normal health, but in diabetes, because of a lack of insulin, the body fails to properly use sugar. Sugars from our food, needed as body builders, are not utilized, but lost through the urine. The strength, vigor and repair of the body falls below par and serious complications then arise.
Normally, sweets and starches we eat are absorbed as sugar and policed in the bloodstream by insulin from the pancreas, so that the body can use it. In diabetes, where insulin is lacking, there is a resulting flood of sugar into the body during eating, and it actually spills over into the urine through the kidneys. The urine is even sweet to taste.
Once the gall bladder has become acutely inflamed, it is likely that a low degree of irritation will persist indefinitely. In the presence of irritating stones, frequent flare-ups may occur to make the gall bladder’s future even more miserable, with continuing indigestions, gas and inability to tolerate fatty, greasy foods.
Some people with gall bladder disease are carried along comfortably by their physician on proper diets, but for the severely diseased and stone-containing gall bladder, the doctor may advise surgical removal. This is particularly true in the elderly patient, who usually will have more difficulty with his gall bladder from year to year.
Sound advise from a good physician in gall bladder disease has no substitute.
Cancer of the Gall bladder. Cancer in the gall bladder usually becomes known only after the gall bladder has been removed because of pain, stones or infection. Cancer is found in about 1 percent of all gall bladders removed, and in this group the outlook is dark indeed.
Gall bladder stones have been blamed for the irritation which is probably responsible for cancer, and for this reason, many doctors recommend removal of the gall bladder whenever stones are found.
The Gall bladder
Gallstones (Cholelithiasis). Gallstones are present in about seven percent of our population. They increase with years, so at
Bile ducts from liver
Fig. 80. The gall bladder looks like a small toy balloon on a branch of the main bile tube which runs from liver to intestines. Water is absorbed from bile in the gallbladder, producing thicker bile. This is similar to evaporating salt water; salts remain and crystallize out to form “stones.” Stones may pass from the gallbladder into main bile tube and obstruct it, causing yellow jaundice, pain and other difficulties.
the age of seventy-five, almost one-third of the people have stones present. Women have four times as much gall bladder trouble as men, and the typical patient with gallstones is “fair, fat and forty.”
Gallstones are formed by the gall bladder itself through its water-absorbing action. Just as salt crystals form in the pan of evaporating salt water, salt or stone forms in bile from which water has been absorbed. From this point, irritation by the stones and inflammation are only steps away.
Gallstones present varying symptoms. Most people have no trouble with them and do not even know of their presence. Others have vague indigestion and are bothered by “gas,” while still others have exceptionally severe pain requiring diet, medication and occasionally an operation. It is well to know that gall-
Fig. 81. The gall bladder when severely inflamed has a greatly thickened wall and may contain stones and pus. It then has the appearance of a boiled lobster.
stones can never be dissolved in any manner, regardless of their kind, location, or length of time they have existed.
Gall bladder Attack (Acute Cholelithiasis). A gall bladder attack usually arises suddenly as a result of gallstones. The irritation started by the stones progresses rapidly to a highly inflammed stage in which the former toy balloon appearance begins to look more like a boiled lobster and the gall bladder, filled with pus, is very tender to the touch. There is usually an accompanying high fever, sweating and chills, nausea and vomiting, and frequently great pain in the right abdomen. The attacks may last a week and are frequently accompanied by some degree of jaundice. People who have had these acute attacks dread another such gruesome episode.
The inflamed gall bladder may have many complications and requires the best medical attention. Frequent severe pain usually convinces the gall bladder patient that the easiest way out is to have his gall bladder removed.
Cancer of the Stomach. Cancer of the stomach is a very serious disease, much rarer than the ordinary ulcer, and found among men twice as often as in women. It accounts for about 30 percent of all cancer deaths each year in the United States, which means that nearly 75,000 people a year die of stomach cancer in this country alone.
This treacherous disease is usually silent in its beginning and
Fig. 79. Cancer of the stomach includes about 30 per cent of all cancer. It can be removed surgically but often is too far grown when discovered. It is thought never to derive from an ordinary ulcer.
remains so until far advanced. Its cause is still unknown, but stomach cancer is found more often among the poor than among the wealthy, and heavy drinkers have much more stomach cancer than nondrinkers.
Like most cancers, stomach cancer is a disease of later years. It might appear in a man of fifty years or over, who has a loss of appetite, indigestion, and possibly pain similar to ulcer distress -relieved by eating food or liquid. Often there is a vague sick feeling in the abdomen, spoiling any desire for food and consequently small meals usually result in weight loss of great proportion. Unfortunately, the story of stomach cancer is not always the same, and frequently early symptoms are ignored. After the age of fifty years, any kind of stomach upset, lasting more than several days, should prompt a visit to the physician for an examination, possibly including an x-ray of the stomach to determine if a cancer problem exists. There is no other disease of the body in which early diagnosis is more important in achieving a final cure than in cancer of the stomach.
Achlorhydria (No Acid in the Stomach). The normal stomach secretes hydrochloric acid, which aids in digestion of foods. Frequently, we find people who have less than the normal amount of acids in their stomachs, and about one out of ten who possess little or no hydrochloric acid at all. When such a situation is found, hydrochloric acid is frequently given along with food at mealtime, and this therapy often results in improved appetite and digestion to the great satisfaction of the patient.
Besides pain, an ulcer can cause three other well-known difficulties.
1. Serious bleeding of an ulcer may occur. This is recognized by vomited blood or black, tarry stools.
2. Blowout (Penetration) of the ulcer produces immediate severe abdominal pain, a grave medical situation.
3. Obstruction to passage of any food caused by long-standing ulcer is recognized by persistent vomiting, and continuous abdominal distress.
Neglect of an ulcer can lead to these serious consequences. On the other hand, it is easy for a competent physician to accurately diagnose an ulcer by evaluating symptoms, examining the patient, and x-raying his stomach. Ulcer care consists of diet, medication and possibly surgery. The ulcer diet excludes ulcer provoking foods, such as spicy, greasy and rough, popcorn-like foods. Medications used in ulcer care are mainly acid blotters and neutralizers, plus drugs, designed to slow down over-activity of the stomach. At least five out of every six ulcers are successfully treated with diet and medication, while the person goes about his daily work routine. About one ulcer out of ten becomes so severe that it can’t heal, and then surgical operations, which have gained high respect, become necessary.
The physician’s advice for ulcer difficulty is most important even after an ulcer is cured. The patient must be informed concerning diet, the advisability of using tobacco and alcohol, and all other items that have an influence upon ulcer disease. Occasionally, an ulcer patient will refrain from seeing his physician because he fears the cure might be worse than the disease. However, most successful patients have just one regret-that they did not seek expert medical treatment for their ulcer earlier than they did.
Peptic Ulcer (Stomach Ulcer, Duodenal Ulcer). A peptic ulcer is a painful sore in the stomach or its outlet, that looks like a canker sore of the mouth, with its crater-like appearance varying from the size of a matchhead to an inch or more in diameter.
Fig. 75. The stomach brings joy to all people at all ages, but it is a victim of modern “push.” Ulcers are believed to be a result of too much stress and “hepped-up” living in a world with an uncertain future. The usual active ulcer appears as an enlarged cold sore or small “volcano.”
We have these ulcers, because the stomach, unlike anywhere else in the body, is continually secreting acids that retard and prevent the healing of sores or ulcerations. Thus is an ulcer born. Pain of an ulcer is easy to identify. It is a burning sensation in our upper abdomen, that goes away with eating or drinking especially milk or alkali. The pain returns when the stomach is empty and the ulcer again becomes a clear target for stomach acids to attack.
Fig. 76. Peptic ulcer is known personally by millions of people. Occurring mostly in men, its burning pain characteristically is relieved by drinking milk, soda or other alkalies.
Fig. 77. Bleeding of some degree eventually occurs in nearly all peptic ulcers, mostly when the base is being eaten away by stomach acids.
Fig. 78. Perforation of the peptic ulcer is caused by severe erosion-digestion of the ulcer base by stomach acids in unusually great amounts. The hole leads into the free abdominal cavity.
Ulcer is a disease of adult life and is about four times more common in men than in women. It occurs and recurs most frequently in the springtime and fall, a fact which has never been explained, but even love and taxation have been offered as possible explanations!