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What happens in endometriosis

Once the fragments of endometrium have implanted they begin to respond to the fluctuating levels of the menstrual cycle hormones in the same way as the endometrium lining the uterus. Thus, the implants thicken and swell with blood and then break down and bleed each month. This blood then cannot escape from the body so it bleeds directly onto the surface of the surrounding organs, causing irritation which leads to inflammation, scarring and, sometimes, the development of adhesions.

As the disease progresses the implants gradually enlarge in size and may form small cysts.

As a cyst enlarges, the pressure within the cyst may cause it to rupture during menstruation, spilling the contents onto the adjacent tissues. This may in turn lead to the development of new implants.

What does endometriosis look like

Classical implants

Until recently, endometrial implants were thought to be fairly uniform in appearance. However, in the last few years there has been a growing appreciation that they have a range of characteristic appearances.

It is now understood that what were traditionally recognized as being classical implants are, in fact, probably only one end of the spectrum of appearances and that they are probably only typical of older implants.

Classical implants usually appear as tiny dots, or clusters of dots, on the surface of the organ or ligament on which they have implanted. They are usually only pinhead in size but they may be up to a centimeter or more in diameter. They range in colour from brown to black depending on how much old blood they contain. When magnified they may look like clusters of black grapes.

Atypical implants

The newly recognized implants are often called atypical implants but they are probably younger implants which, as yet, have very little old blood deposited in them.

Atypical implants are usually very small and are sometimes difficult to see. They may occur alone or in clusters and may be clear, white, yellow, orange or red in colour.

Microscopic endometriosis

In the early stages of endometriosis the implants may be too small to be seen without the use of a microscope. This type of endometriosis is often referred to as microscopic endometriosis.

Endometriomas

Endometrial cysts on the ovary are also known as endometriomas. They are usually less than two or three centimeters in diameter but occasionally may be 10 or more centimeters in diameter. They may be embedded in the ovary itself or they may lie on its surface. They are sometimes referred to as ‘chocolate cysts’ because they contain old dark blood which often has the appearance and consistency of melted chocolate.

Adhesions

Adhesions are bands of tissue which bind or matt together organs of the pelvic cavity and they may be formed as a result of endometriosis. They may have the appearance of sticky toffee which has been stretched from one organ to another.

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It would be quite wrong to suggest that all illness could be abolished by ‘right living’, but there is no doubt that changing one’s lifestyle and behaviour even a little can result in a greater resistance to illness and quicker recovery from disease.

Most of us have become sloppy about the way we run our lives and often have only ourselves to blame when things go wrong. We flagrantly abuse our minds and bodies and then wonder why they let us down. I put ‘minds’ first because as many as three-quarters of all symptoms are caused by emotional and psychological disease. Don’t forget that the largest group of prescriptions written in most western countries is for mind-altering drugs. We also try to cope with the stresses and strains of modern life by the frequent consumption of cigarettes, alcohol and caffeine- and cola-containing drinks-all of which have provable harmful effects, at least in some people.

It is an old truism that ‘you are what you eat’ and it is certainly a fact that you can only get the nutrients essential for the healthy working of your body by eating them.

We are all brought up to believe in the ‘balanced diet’ but the adequacy of the sort of protein-and-two-veg regime generally designated by this phrase is almost certainly a myth. A 1980 study (and there have been many over the years throughout the western world) found that only 15 per cent of the UK residents interviewed were consuming a diet that could provide even the minimum dietary requirements as laid down by the Department of Health and Social Security and these are themselves reckoned to be too low by many experts. In the USA two workers did a detailed study of 860 dental patients and found that almost half had frank vitamin and mineral deficiency states and that 6 per cent had no vitamin Ñ in their blood at all. Another US study found that 88 per cent of 120 randomly selected people had a significant deficiency of at least one vitamin and that 63 per cent were deficient in more than one. As we learn more about minerals it is becoming apparent that most people are short of these too.

Unfortunately, most people think that if they eat a little of a wide variety of foods their body will somehow balance out the goodies and end up healthy. Modern research has proved otherwise. Evidence now suggests that modern farming practices, which deplete the levels of essential nutrients in the soil by intensive cropping, mean that even the starting point-plants and animals from agricultural sources-are poor in all kinds of essential substances. Intensive farming methods, drugs used to fatten animals and so on, have provable negative effects on our health and nutrition. A further loss of vitamins and minerals occurs between the picking and the eating as modern food processing removes much of what is left. Few people realize the grave deficiencies of their modern diet, yet government departments repeatedly assure us that all is well.

All the above assumes that the consumer is really trying to eat healthily-and I am saying that this is very difficult to do, however well motivated one is. But the vast majority of the population doesn’t try. They consume large amounts of sugar, white-flour products, fat and alcohol, and suffer considerable nutritional deficiencies as a result.

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Janet Parent knew that to lose weight, she needed to gain control of her eating habits. She did it with milk.

Janet grew up in a family whose clean-your-plate philosophy was largely responsible for her eventual size-14 figure. Over the Ik I years, she dieted time and again, sometimes shedding a few pounds. But she’d lie awake at night, feeling starved. Inevitably, she’d return to large meals and constant snacking. Over a lifetime of gaining, losing, and regaining, Janet watched herself hit a high of 164 pounds. Finally, at age 64, the Old Forge, New York, resident became determined to slim down. “It was either buy yet another new wardrobe or take off the weight,” she says.

Her first step was to drop her drastic dieting and go back to preparing and eating her regular foods. For Janet, that meant meals of steak, potatoes, and corn; or chicken, rice, and broccoli—both always served with a salad. The main difference was that she began to leave a little food on her plate at the end of every meal.

This trick helped Janet control her portion sizes. But she still craved snacks. So she tried drinking skim milk between meals as a way to take the edge off her hunger. “I like the taste of milk, and I knew from experience that drinking it made me feel full,” she explains. “Besides, the extra calcium is good for my bones.” She also ate an orange every night before going to bed, to keep her stomach full until morning and stave off the midnight munchies. Slowly but surely, the extra pounds came off—and have stayed off for 2 years.

Today, at age 66, Janet weighs 147 pounds and wears a size-10 dress. “Drinking milk is the easiest thing I’ve ever done to lose weight,” she says.

WINNING ACTION

Satisfy your hunger with skim milk. A cold 8-ounce glass of skim milk is not only filling but also healthy—a great source of bone-building calcium. If you aren’t a fan of skim milk, try 1 percent. It has a richer taste but each

serving still gets fewer than 30 percent of its calories from fat. If you’re a chocoholic, add 2 tablespoons of Her-shey’s Syrup for a fast chocolate fix with only 50 calories and no fat.

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Some doctors use short courses of corticosteroid tablets for patients with chronic urticaria, to allow the irritation to settle down before other treatments are tried. In very severe cases of rheumatoid arthritis, corticosteroid tablets are sometimes used (see Section 5). A corticosteroid injection into an affected joint can reduce inflammation for some time.

In eczema, corticosteroid creams or ointments are used when other forms of treatment (see Section 6) have failed. The creams, ointments and other preparations are classified into four groups: mildly potent, moderately potent, potent and very potent. In general, only preparations in the first two groups are prescribed for children, since there is a risk of stunting and other side-effects when corticosteroids are absorbed into the bloodstream (see p319). Even in adults, the potent and very potent preparations are generally only used for a few weeks, to control an acute outbreak of skin irritation; a less potent preparation is then substituted.

The amount absorbed depends on certain other factors, besides the potency of the cream or ointment. More will be absorbed from the face and genitals, and creams should be used sparingly in these areas. Damaged skin will also absorb more.

If corticosteroids have been applied to the skin for more than a few weeks, treatment should not end abruptly, or there may be a flare-up of the eczema. The cream should be withdrawn gradually, a little less being applied each day. The corticosteroid cream can be used alternately with an emollient (see Section 6) to ease withdrawal.

In general, treatment with mildly potent corticosteroid preparations can be continued for as long as necessary. Provided there is good medical supervision, such treatment can safely continue for several years if needed.

The corticosteroids most commonly used in creams and ointments for eczema is hydrocortisone.

Creams and ointments used for eczema often contain other drugs, besides the corticosteroid. Some include antibiotics and/or anti-fungal drugs, to treat secondary infections. Others contain substances that help to reduce itching, soothe the skin, or restore its water content. Preparations containing a mixture of coal-tar (which reduces itching! and hydrocortisone (eg Carbo-Cort) are often very effective, the coal tar helping to make the hydrocortisone effective, even at a low dosage.

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This is also known as intradermal neutralization therapy, or the Miller technique, after Dr Joseph Miller of Alabama who has spent many years developing it and investigating its potential. The treatment can be applied in two ways – either using injections of food extracts under the skin, subcutaneous injections, or giving food extract drops under the tongue, sublingual drops. In both cases, the doctor establishes a particular dose of the food extract that will ‘turn off or ‘neutralize’ the symptoms caused by that food.

To test for the correct dose, intradermal injections, which put food extracts into the skin, are used. Intradermal injections place food extracts deeper in the skin than skin-prick tests (see p30). A tiny amount of food extract is used – 0.05 millilitres. If the body does not react to this extract it simply produces a small raised area, known as a wheal, which begins to go down soon afterwards. If the body does react, then the wheal grows slightly, and takes on a characteristic appearance – it is white, hard and raised, with a sharp edge. This is known as a ‘positive wheal’ At the same time, the patient may experience symptoms similar to those that are normally produced by the food – this is the ‘provocation’ part of the test.

The ‘neutralization’ part of the technique is based on the finding that a particular concentration of the same food extract will put a stop to those symptoms. Such a dose also produces a ‘negative wheal’ – one that is white, hard and raised but does not grow larger. It is usually the same size ten minutes after the injection.

The neutralization dose is usually the strongest solution that fails to produce a positive wheal, so it is determined by starting with a solution that does produce a positive wheal and then working gradually downwards. Using this method, the neutralizing dose can be determined even though the patient has no symptoms at the time – the wheals alone show when the right dose has been reached.

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As soon as you can, start keeping a daily record of your symptoms. This might seem rather unnecessary at this stage, but it will prove very useful later. The main purpose is to give you a detailed picture of how you felt before you began the diet – a base-line to which any later state of health can be compared. It is remarkable how quickly the memory fades – especially the memory of illness. If you only make a partial recovery, as some people do, you may later forget how ghastly you felt at the outset, and begin to think that the improvement is very small. Looking back at your symptom-record is often a startling reminder, and it can help strengthen your resolve to persist with the diet. It is also valuable if friends or relatives start to question the usefulness of what you are doing – you may need to prove to yourself that you really are better.

At the same time, you could also make a record of what you eat. Some people are more conscious of what passes their lips than others, and when you come to plan your diet you need to be aware of what foods you eat very regularly. Keeping a food-diary for a week or two can be quite an eye-opener. It will also get you into the habit of reading ingredients labels and watching out for synonyms.

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With breast-fed babies who are thought to have food sensitivity, the first step is to check that it is not something other than breast milk causing the problem. Think about what else the baby consumes, and if possible eliminate everything except breast milk, including medicines (with your doctor’s approval), vitamin drops (which often contain artificial colouring), fruit juices and any solids. If the baby needs to go on taking medicines or vitamins, ask the doctor to prescribe something that does not contain any colouring or other unnecessary ingredients. You may need to give boiled water to compensate for fruit juices or other extra liquids that you have withdrawn.

If this has no effect, the next step is to compile a list of suspect foods from those that you are eating. Keep a record of everything you eat, recording the quantities and times of eating as well. Make a separate record of your baby’s symptoms, with the time, duration and intensity. Continue this for a week or two, and compare the two records to see if there are any likely suspects. The time interval between the mother eating the food and the baby suffering symptoms can vary from one day to several days.

Don’t make the mistake of thinking that it must be cow’s milk, just because this is the food problem that we hear about most often in babies. For the exclusively breast-fed baby, it could be any food. However, babies who have received supplementary bottle-feeds are more likely to react to cow’s milk than anything else. Even if you have never given a bottle feed yourself it is possible that the baby received one from a nurse while in the maternity ward.

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Are antigens and allergens fundamentally different from each other? This is a question that causes a lot of confusion and it is worth spending some time looking at what these two words actually mean.

An antigen is any molecule that can provoke the body into producing antibodies to it. To do this the molecule must be above a certain size, because the B cells and their colleagues in the immune system are programmed to ignore very small molecules. So simple chemical molecules such as water or salt cannot act as antigens. However, some quite small molecules, that are too small to act as antigens on their own, may combine with proteins in the body, thus producing molecules that are large enough to be recognized by the immune system. Small molecules of this sort are called haptens.

Living organisms are composed of a great variety of chemical compounds, and some make more effective antigens than others. The important point about an antigen is that it should have at least one distinctive chemical structure on its surface – a chemical ‘handle’ that the antibody can grab hold of. This structure, which the antibody fecognizes, is called the epitope.

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Petadolor is not as fast-acting as many chemical medicines, but its harmlessness no doubt offsets this small disadvantage. In approximately 50 per cent of patients who take it the pain-killing effect is relatively fast, but in 30 per cent it is slower, taking about an hour to counteract menstrual cramps and migraine. In approximately 10 per cent of patients, especially cancer patients, it begins to work only after about three days, but then the effect is stronger than that of morphine. About 10 per cent of all patients respond very little or not at all to the remedy. It may be, however, that in time a greater concentration of the active substances will bring relief to these people too.

Since Petadolor is able to ease cramps and spasms, it helps to calm and tone the nerves. Faster results are obtained when Petadolor tablets are dissolved on the tongue, because in this way the active elements are dissolved by the saliva and absorbed via the mucous membrane.

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Is it a good thing to get rid of foot sweat? Or is perspiration a natural process through which the body disposes of toxins that it could not otherwise eliminate? This second assumption seems to be correct, or else so many unpleasant consequences could not have resulted when sufferers tried to suppress perspiration of the feet.

Just recently I received a letter from a woman in Zurich telling me that while her husband was doing military service his foot sweat was suppressed and as a result he developed a skin disease. Foot sweat is often suppressed by people in military service, but this is no cure; rather, it can be detrimental in as far as the effects will be either a skin disorder or some other problem. For example, I have never found a person suffering from any form of lung trouble to be plagued by excessively sweaty feet. Specialists in lung diseases with whom I have discussed this phenomenon have confirmed my observation. Hence the logical conclusion that the direct and deliberate suppression of foot perspiration or some other excretory body function, can mark the beginning of lung problems or may be connected with them. If you want to get rid of the troubles incurred there will be no other way but once again to induce the feet to sweat. You may wonder how this can be done. Well, the suggestion below is simple enough, but carrying it out successfully is quite another matter.

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