Archive for October, 2006
Colitis. Sometimes named irritable colon, colitis is a very common disease intimately associated with the nervous system. Its main characteristic is frequent painful spasms of the colon along with periods of diarrhea and constipation. There is no definite cause of colitis but its beginning appears to involve emotional factors concerned with disappointments in life greater than one can stand. A person afflicted with colitis is said to be “speaking with his colon” when he cannot speak with words.
Relief from colitis is frequently obtained when the state of tension or nerves is properly treated. This is best accomplished by a person schooled in the ways of psychological lessening of fears and tensions. Occasionally a difficulty thought to be colitis is found to be caused by foods, drugs or allergies of unsuspected sources. Fortunately, these cases mistaken for colitis are completely cured with dietary restrictions regarding foods or avoidance of particular drugs.
Diverticulitis. Diverticulitis, sometimes called left-handed ap-
Fig. 90. Diverticulitis is caused by inflamed out-pockets which become sore and resemble appendicitis. It is found in 1 out of 20 adults and frequently causes bleeding found in the bowel movement.
pendicitis, is distinctly a disease of the later age group. It is an inflammation of the many appendix-like outpockets in the colon, which occur in about five percent of all people over the age of forty and like the appendix, these outpockets become inflammed and a source of severe pain and bleeding. It is usually the constipated, obese and older person who has most difficulty with this disease, because the number of diverticulae present in the colon increases with age.
The irritation in these diverticulae is thought to originate with seeds or other small particles in the fecal material. Prevention of diverticulitis then embraces a diet which eliminates seeds, bones, nuts and other sharp articles which can easily lodge within these outpockets and start trouble. In severe cases of diverticulitis, surgery may become necessary to remove the segment of colon seriously inflammed. This disease frequently is suspected to be cancer of the colon and necessitates a close investigation by a physician to make the correct diagnosis.
Appendicitis may be most difficult to diagnose, even for the expert physician, and no one should attempt to make this diagnosis on himself, not even a doctor. Everyone, however, should include some information about a typical appendicitis picture, because over 2,000 deaths a year in the U. S. might be prevented if only the possibility of appendicitis were considered in time.
The usual story of appendicitis might begin with vague nausea, progressing gradually to vomiting. Moderate pain is felt all over the abdomen at first but it gradually localizes low in the right side. A soreness in the appendical region along with fever and possible bloating help to complete the picture. The whole process may begin and grow to obvious proportions in six to twenty-four hours.
In contrast to this usual story of appendicitis, is the atypical course of the disease in later years. The patient with a severe attack of appendicitis, may appear to be only slightly ill for the first several days. Nausea, if present, frequently does not progress to vomiting. Pain in the abdomen might be only a slight discomfort, and may not localize into the lower right side of the abdomen. Temperature usually is not elevated in proportion to the seriousness of the disease.
This picture might easily be more complicated by the presence of other chronic disease symptoms, such as constipation, arteriosclerosis or gall bladder disease. This explanation helps us to understand why appendicitis in later life is more dangerous, and that after the age of fifty, abdominal pain should not be “taken like a man,” but handled more wisely by calling the family physician.
The colon, or large intestine, consists of the final five feet of the intestine and measures about one-fifth of the entire intes-
Fig. 88. The pathway of food within the abdomen includes a small storage depot-the stomach; a digesting and absorbing tract-the small intestine; and the collecting, condensing and excreting mechanism-the colon. The stomach and colon are subject to many diseases; the small intestine relatively few.
tinal tract. Its primary function is the condensing of residue as it nears the anus for the final defecation of this waste material. Defecation is mostly an automatic mechanism, but as is well-known, this reflex easily can be subdued and controlled by the will. Very little regard is given to the colon for its contribution to routine civilized living, however, there is obvious truth in the saying, “civilization itself is founded upon an intact sphincter of the colon.”
Appendicitis. The appendix, attached to the first portion of the colon, has gained great notoriety in people of the upper age group. Usually we think of appendicitis as occurring in children and young adults, and this thinking is correct. People under forty years of age have four out of every five cases of appendicitis,
JUNCTION OF SNVAU INTESTINE TO LARGE INTESTINE
Fig. 89. Appendicitis still claims over 2000 lives annually in the United States. It occurs most often in youth but is far more dangerous and produces most of its fatalities in senior years.
and less than one in a hundred die. However, one out of every five cases of appendicitis is found in people over forty years of age, and in this age group are found three-fourths of all deaths from appendicitis. This forces the conclusion that appendicitis is about twelve times more dangerous if we should have it after the age of forty years.
As if to prove this, approximately 2,500 United States citizens die each year from appendicitis, and most of the deaths occur between the ages of sixty-four and seventy-four years. Although appendicitis is much more common in youth, it is obviously much more serious in later years because:
1. The aged appendix has a much weaker defense mechanism than it had in youth, and the infection develops much faster and more seriously.
2. The appendix, which is not difficult to recognize in youth, is usually labeled “atypical,” in later life, and the usual symptoms of appendicitis are much harder to recognize.
3. We grow accustomed to aches and pains here and there. Many of these difficulties are well tolerated with a little patience, but a serious attack of appendicitis may hide among these every-day irritations until irreparable dam
age is done, and treatment is futile.
Hepatitis. Often caused by a virus, hepatitis is an infection of the liver in which painful swelling of the liver may be felt on the right side. It is a disease which may have a long course to recovery, with an uncertain future, but most patients eventually make a recovery. This disease has a slow onset, and is accompanied by a usual fever, a distinct loss of appetite, vomiting and diarrhea. Jaundice also frequently occurs with hepatitis, a disease which demands the very best of medical care.
Cirrhosis of the Liver. Although cirrhosis is about the best-known liver disease, it is still poorly understood. The liver has a roughened, hobnail appearance which was formerly thought to be the direct result of chronic alcoholism. As its cause still remains a mystery, it may exist undetected for many years.
Fig. 87. Cirrhosis of the liver creates a hob-nailed appearance and leathery texture. Sometimes connected with chronic alcoholism, the disease means eventual destruction of the liver and death.
Occasionally, swelling of the abdomen from an accumulation of watery fluids within may arouse the patient’s suspicion that something is wrong. At other times sudden vomiting of large amounts of blood from a ruptured, enlarged vein within the stomach is the first indication of disease. In the late stage of cirrhosis, blood cannot circulate easily through the liver and is forced to find and build new channels through which to flow. Large veins can then be seen on the surface of the abdomen and the skin covering the chest wall of these individuals. Cirrhosis usually is diagnosed after it has existed a long time, and is then considered incurable but the physician can usually prolong life comfortably through medication, blood transfusions, diet, and other measures.
Obscure Liver Disease. Other diseases of the liver are commonplace, but they are poorly understood and difficult to recognize even by experienced physicians. Continued study of liver function and disease is being carried on constantly in many medical research programs.
Jaundice. Yellow jaundice is a diseased state in which bile accumulates in the blood stream, and colors all the body tissues yellow. This is first noted in the whites of the eyes, but eventually it covers the entire body and may even be seen in urine
Fig. 85. The liver is normally smooth and soft, and weighs about five to eight pounds in adults. The “factory” organ, it manufactures many body necessities, but its functions are so numerous that not all of them are known.
and perspiration which may have a yellowish tint.
Jaundice, a complex medical problem, is usually caused by one of three situations.
1. It may be an inherited disease, involving the spleen.
2. It may be due to gallstones blocking the duct from the liver.
3. Jaundice may be caused by an infection of the liver itself, called hepatitis.
Uncovering the exact cause of jaundice may be a very taxing problem even for the most learned of physicians. Besides requiring an accurate and lengthy history of the jaundice, a de-
Fig. 86. The liver ordinarily is tucked up under the ribs, but in disease may enlarge greatly to occupy nearly half of the abdomen. In such diseases, it becomes quite tender and is occasionally accompanied by jaundice.
tailed examination is necessary along with numerous laboratory tests to confirm or dispel all possibilities. We should realize that only the physician is qualified to recognize the extremely serious possibilities of this disease, and though its cause may be deeply rooted, jaundice is often completely relieved through good medical treatment. Delay in seeking adequate treatment may be foolhardy, but attempts at home remedy or drug store cures for jaundice are open invitations to disaster.
Several difficulties attend the diabetic person. Probably the best-known of these difficulties is diabetic coma, where the diabetic condition actually produces unconsciousness. Many diabetics carry cards on their person, informing strangers what to do for them in case they should be found unconscious. Another well-known difficulty of diabetics is poor blood circulation, especially in the toes. Unfortunately with the diabetic of senior years, gangrene of the toe may become rapidly apparent following the slightest injury or infection, and the most delicate care is necessary to prevent such unfortunate complications.
Diabetes starts most often between the ages of forty-five and fifty years, twice as often in women as in men, and especially in married women who have had children. Diabetes seems to be a racial characteristic which afflicts the Jewish race heavily for some unknown reason. Inheritance also is a factor in diabetes and if any one of our close relatives is found to have this disease, we ourselves are possible candidates and an examination for diabetes is in order.
The biggest reason for diabetes seems to be “obesity.” The reason is not clear, but schooled opinion exists that the fat person is continually looking down the gun barrel of diabetes. Stress also is thought responsible for bringing about diabetes, and the stress of a severe burn, high fever, pregnancy or severe emotional upset is very often the straw that breaks the back of the diabetic candidate. Examination after such episodes often reveals, for the first time, the presence of diabetes.
Control of diabetes means control of sugar within the body. In light diabetes, restriction of sugar in the diet may be sufficient, but in severe diabetes, insulin (which should have been manufactured by the pancreas) becomes necessary for effective treatment. Diabetics usually wonder why they cannot take insulin by mouth and the reason is that the hormone insulin, is also a protein, and if taken by mouth like other foods, is simply digested away. There is beginning use, however, of drugs taken orally which do have a pronounced effect in some cases of diabetes, and eventually it is probable that complete treatment of diabetes may be entirely by the oral route rather than by the unwelcome hypodermic route.
Effective treatment of the diabetic person whether by diet restriction, insulin usage, or both, usually enables these people to carry on a normal and active life within very wide boundaries.