illness explained

Why you fall ill

YOUR HEALTH / DR GITA MATHAI

An illness is always unwelcome but before knowing how to keep it away, we have to know what causes it. Ancient people believed that diseases were due to an imbalance between “heat” and “cold,” or because of possession by “spirits”. Today we know that diseases are caused by infectious agents (bacteria, viruses, intermediate organisms), genetic make up, nutritional excess or deficiency, immunological status, metabolic causes and faults at the cellular level. Almost all diseases fall into these basic groups, with some overlap, irrespective of the organ system where symptoms first manifest themselves. The body’s reaction to these external and internal forces determines the intensity and the duration of the disease. The body may be defective from birth, so much so that it may be incompatible with survival. Such a child may die in utero, soon after birth or in early childhood. Severe heart, kidney, liver and nervous system defects and multiple congenital abnormalities fall in this category. Today, many defects can be surgically or medically tackled, resulting in a normal lifespan. Many infectious diseases can now be cured with appropriate antibiotic, antiviral and anti-parasitic agents. However, overuse, self-medication and misuse of drugs has resulted in the emergence of some “super strains” of bacteria that may be lethal. Many infectious diseases can be prevented by immunisations started in childhood and continued in adult life. Examples are diphtheria, whooping cough, tetanus, small pox, polio, typhoid, chicken pox, jaundice (owing to Hepatitis A and B) H infuenzae (ear infection, meningitis), meningococcal meningitis, Pneumococcus (ear infections, pneumonia, meningitis), measles, German measles, mumps, HPV (which is responsible for some cancers), seasonal flu and Herpes Zoster. Unfortunately, 60-70 per cent of Indian children are incompletely immunised. Either the schedule itself is not finished or the boosters are not given. Sometimes vaccines that have to be given when the child is older are missed altogether. The elderly seldom take the immunisations they require. Diseases occur when the body’s cells refuse to obey centralised commands. They are suppose to regenerate and die in sequence, but if the balance is not perfect, diseases occur. When the regeneration slows down, hair falls out, bones become weak and memory suffers, among other things. If proliferation overtakes degeneration, cancers occur. The metabolic functions of the body are controlled by endocrine glands and enzyme reactions. These can fail or malfunction for genetic reasons, infections or age. This results in a gamut of diseases such as diabetes, hypertension and thyroid problems. In some people the body fails to recognise its own cells. It perceives some cells as alien and attacks them with a vengeance, destroying them and setting off cascading reactions with deleterious effects all over the body. This produces the spectrum of auto immune diseases such as rheumatoid arthritis and system lupus erythymatosis (SLE) and can lead to the destruction of bones, joints and many organ systems. Irrespective of the disease, patients want an immediate cure. In the case of an acute infectious disease, with proper diagnosis and adequate treatment a total cure is possible. But this takes time. Impatient and frustrated, patients may “doctor shop.” This can result in frequent changes in the antibiotic used or the addition of disease modifying steroids to rapidly eliminate symptoms. This does more harm than good. Meanwhile, many acute diseases “run their course” and are cured anyway. Chronic diseases such as arthritis, diabetes, COPD (asthma), seizures or cancer are often frustrating. There seems to be no cure in sight, and a lifetime of medication appears depressing. People are often tempted to try out other systems of medicine or natural cures. These, anecdotally or through advertisements, appear to have fewer side effects and offer a cure. Often, the basic defect is still present and the medication just has a placebo effect. When receiving treatment, do not mix up systems of medicine. Allopathic medicine encourages an evidence and diagnosis-based approach. Many other systems have a symptom-based approach to diagnosis and treatment, even though the same symptom (like jaundice) can appear in many disease processes. The medication taken under various systems can produce drug interactions. These may be difficult to diagnose and tackle. Our body needs to be nurtured from birth. We should restrict the number of chemicals we consume. This means avoiding processed infant foods, snacks with trans fats, coloured and caffeinated beverages, alcohol and nicotine in tobacco products. Genetics and the environment may make our bodies prone to certain diseases but with a healthy diet, an hour of exercise a day and adequate sleep, we can often offset these deleterious effects. Dr Gita Mathai is a paediatrician with a family practice at Vellore. Questions on health issues may be emailed to her at yourhealthgm@yahoo.co.in