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What you need to know about inflammation

by James Davies


Dr. Sylvester Ikhisemojie

There are many people that believe that inflammation is a disease by itself. When they perceive swellings anywhere in the body, therefore, they refer to it as inflammation. To a certain extent, they are correct. But inflammation is partly made up of that and other components such as pain and redness. In a truly dark-skinned person, these differences in colour may be difficult to see.

Inflammation is an intrinsic part of the defence processes undertaken by the body when our tissues detect the presence of an intruder. Like we often see in real-life situations when we do not want to see certain things happen, the body mounts a protective mechanism to try and defend itself; that effort may be immediate or delayed and it could be gradually incremental over a long time such that it is present throughout our life span.

The substance that attacks the body may be something like a shard of glass or an irritating substance like a chemical or a micro-organism such as bacteria, viruses, fungi and parasites which cause diseases we label as infections. In some circumstances, the nature of biological responses takes the form of an attack on itself when the body fails to recognise such tissues as being a part of itself. When that happens, an autoimmune disease results.

Examples of autoimmune diseases are systemic lupus erythematosus, which we have dealt with on this page or more commonly, type 1 diabetes which we have also discussed here. Whatever is the case, there is a consensus in the research community that inflammation constitutes a defence mechanism for the body as a whole and that the process plays a unique role in the body’s healing following an injury or attack.

When there is an inflammation in the body, there are biological ways of mapping such inflammation, and these markers are known as biomarkers. They can be found when a person has got an infection or when there is cancer in the body or even when there is a recent change in diet. Exercise and obesity are other situations in which one such biomarker, called C-reactive protein, (CRP) is found to rise.

This range of activities is launched when there is a physical factor involved in setting it off while the body is compelled to mount an inflammatory response to stop it. An inflammation, therefore, does not always mean that there is an infection but an infection will always cause an inflammation. Consequently, inflammation has been divided broadly into two: acute and chronic inflammation.

An injury sustained in any part of the body can give rise to an acute or short-term inflammatory process. There are key signs that acute inflammation is present in the body and these are discussed below. There are five such features;

Pain: This is an important component of the inflammatory process and may be present for a short period of time or over a long term. It may become a part of the person’s daily experiences or be elicited only when the area is touched.

Swelling: As a direct affectation of the pain above, the area involved is typically swollen and can develop over a short or long period depending on the nature of the causative agent. Fluid builds up inside the tissues causing what is known as oedema.

Heat: The swelling which develops leads to an increase in the flow of blood into the area so that there is an increase in the local temperature and that makes it feel warmer than the surrounding area.

Redness: With all the developments above, the area around the injury or assaulted tissue becomes red as blood supply increases to the place.

Loss of function: Often, there could be some difficulty with moving the affected part of the body especially if a joint is involved and if any part of the respiratory apparatus is involved, there could also be some difficulty with breathing.

However, these signs don’t need to be present at all times. Sometimes, the signs of inflammation are more subtle with the person just feeling tired, with associated fever and a general feeling of being ill. Such signs of acute inflammation may last only for a few days before it progresses into the chronic stage which can linger for several months or even years. This particular sub-group of inflammation often becomes associated with a number of disease conditions in the body which we shall briefly name here.

Therefore, in acute inflammation, the body typically accumulates plasma proteins and that causes fluids to build up in the affected tissues resulting in some swelling as we mentioned above. Following closely upon this development, the body then releases white blood cells to the affected area.

The fraction of the white blood cells that does this work is known as neutrophils and they contain certain molecules that mount an attack against the invading organisms. Lastly, the small blood vessels, called capillaries which we discussed several weeks ago when talking about the blood circulation, then enlarge so that plasma proteins and white blood cells can more easily get to the site of the injury.

Signs of acute inflammation can become evident within several hours or even days depending on the cause. In some cases, they can progress rather quickly and become quite severe. The pattern of development, the rate of progression and how long these last will depend on the nature of the invader, the characteristics of the person attacked and what part of the body is affected.

Acute inflammation can result from exposure to a substance such as a bee sting which we discussed on this page a couple of months ago, or to dust. It can also result from an injury and these include those sustained from surgical operations. Finally, it can result from any kind of infection. There are some infections and other factors that commonly show us how acute inflammations can be.

These situations already have affected many of us and we often take what medications we are asked to and move on; some of these conditions are sore-throat from common cold or flu, tonsillitis from bacterial infections, acute bronchitis, appendicitis and any other ailment whose spelling ends with “itis”, ingrown toenail and physical trauma or wounds. About four years ago, we discussed certain considerations on this page that must be satisfied to label a tissue as an insult to a wound and we talked about some of these features then.

Acute inflammation can cause pain of varying intensity and types. The combination of factors we discussed above clearly demonstrates how these mechanisms are brought about. Such pain may be constant and have a throbbing nature. It may be steady, persistent and continuous. It may be pulsating and pinching in nature or it may be intermittent and twisting.

The pain may announce its presence with severe paroxysms and remain for several minutes and then disappear as if nothing ever happened. It all depends on the cause. And as it often happens when there is a headache, it may give rise to a banging sensation in the head that is ultimately unbearable. Many Nigerians will not go to the hospital unless they are in pain, or are not able to eat or when they are bleeding.

Therefore, for many of us, it is important to understand how inflammation modulates pain and why pain is variable. That understanding helps the doctor a great deal in understanding what may be wrong with a patient and provides them with the suspicion that should guide what kind of investigations are requested to confirm these problems. The issue of inflammation is a big one in our lives and we cannot exhaust it in one essay. Therefore, we shall continue next week.

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