scar tissue: america’s number one cause of chronic pain, chronic illness, and death

DEATH BY SCAR TISSUE (FIBROSIS)
HOW MANY OF YOU REALIZED THAT SCAR TISSUE IS AMERICA’S #1 CAUSE OF DEATH?

Fibrosis Death

When you think of the Western world’s leading causes of death, old standbys come to mind like DIABETES, CANCER, HEART DISEASE, COPD, and others of similar ilk.  But what if I told you that the statistics are wrong — or at least not completely accurate — not telling the whole truth about what’s really killing these people?  What if I told you that the number one cause of death in America (JUST IN FRONT OF THE SECOND LEADING CAUSE OF DEATH — MEDICAL CARE) is Scar Tissue?

Although I use the term “Scar Tissue” with my patients because it’s easy for them to understand and already holds certain connotations, the medical community uses the word “Fibrosis”.  No matter what anyone tells you, these are the same entities (HERE).  And while Scar Tissue is responsible for any number of chronic pain syndromes (HERE), how shocking would it be to learn that it is America’s number one cause of death as well?  Enter Dr. Thomas Wynn.

Dr. Wynn is a respected and highly decorated senior researcher for the NIH.  He is a microbiologist and director of their Immunopathogenesis Section.  Although his primary specialty has to do with specific inflammatory reactions caused by specific kinds of PARASITES, his real area of expertise is researching the INFLAMMATION / FIBROSIS CONNECTION.  According to the NIH website, Dr Wynn’s job is to figure out, “the mechanisms of fibrosis.”  The reason for his quest is simple — finding a compound that can be turned into a blockbuster drug for getting rid of Scar Tissue, but sparing normal tissue.  What do we currently use right now?  According to Wynn, “Although fibrogenesis [the genesis or ‘birth’ of fibrosis] is increasingly recognized as a major cause of morbidity and mortality, there are few—if any—treatment strategies that specifically target the mechanisms of fibrosis.”  Why is this important to know?

When Wynn uses terms like morbidity and mortality, he means disease and death.  I’ve already mentioned some of the heavy-hitter diseases in the top paragraph, but as for death, can Scar Tissue really cause death?  Not only does it cause death, it causes it on a scale grander than you could have ever imagined.   Dr. Wynn minces no words when he states via his NIH bio that, “nearly 45 percent of all deaths in the developed world are attributable to fibroproliferative disorders.”  In other words, out of the 2,626,418 deaths that occurred in the United States in 2014, approximately 1,180,000 were the direct result of fibrosis.

The truth is, this number is probably low since the stats are two years old.  Face it; people have not gotten healthier — less inflamed — over the course of the past couple of years.  Secondly, if you understand the basics of the process, you have a better chance of saving yourself from the possibility / probability of a long, drawn out, and miserable death.  You see, it’s not so much that people are, as JT sang about almost three decades ago, DYING YOUNG, it’s that people are dying after years — sometimes decades — of misery and suffering.  It’s a scenario that drug companies absolutely love because it usually means that people are on lots of drugs for a very long time (HERE). 

If you are tired of being not only being BIG PHARMA’S lackey (Webster’s: “servile follower“), but their lunch ticket as well, it might be in your best interest to understand a single paragraph written under Dr. Wynn’s biography.  We’ll get there, but first you need to grasp a couple of essentials as we move forward.

WHAT IS FIBROSIS AND HOW DOES IT KILL YOU?

In an academic article published in the Journal of Pathology called Cellular and Molecular Mechanisms of Fibrosis (the author, Wynn, cites 175 studies in his bib), Dr. Wynn answers the first part of the question raised by the title of this section.  “Fibrosis is defined by the overgrowth, hardening, and/or scarring of various tissues and is attributed to excess deposition of extracellular matrix components including collagen.”  Most of you have at least an idea of what COLLAGEN is, but what is the ECM (extracellular matrix) and what is it’s job?  That question is answered by another scientific article (The Extracellular Matrix at a Glance) published in the Journal of Cell Science (quote is cherry-picked as are most long quotes I use).

“The extracellular matrix (ECM) is the non-cellular component present within all tissues and organs, and provides not only essential physical scaffolding for the cellular constituents but also initiates crucial biochemical and biomechanical cues. Although, fundamentally, the ECM is composed of water, proteins and polysaccharides [long chains of sugar molecules], each tissue has an ECM with a unique composition and topology.  Moreover, the ECM is a highly dynamic structure that is constantly being remodeled. Through these physical and biochemical characteristics the ECM generates the biochemical and mechanical properties of each organ, such as its tensile and compressive strength and elasticity, and also mediates protection by a buffering action that maintains extracellular homeostasis and water retention. Acute injury activates the fibrogenic machinery and induces wound healing.

In a healthy tissue, once the wound has been repopulated [with collagen and ECM], strict feedback mechanisms are initiated that ensure restoration of tissue.  Under extreme conditions, such as repeated injury, these aberrant conditions promote chronic vascular remodeling and enhanced ECM crosslinking that eventually leads to aberrant fibrosis and an inability of the tissue to heal properly. This aberrant wound healing scenario is characterized by the altered mechanical stability and reduced elasticity that is typical of scarred tissue. In extreme cases, a chronic wound can also promote a tumor.”

Did you catch all this?  Scar Tissue is bad news that can lead not only to chronic pain, but to sickness, disease, and death.  It does this by creating a microscopically “crosslinked” HAIRBALL-LIKE WEB OR NET of aberrant collagen and ECM.  This web not only causes mechanical restriction, but THICKENED TISSUE IS WEAK as well as hypoxic, effectively acting to choke off the blood supply via entangling and then strangling the capillary beds, which causes low OXYGEN levels and pain, as well as an impaired ability to heal. The important thing to remember is that this process can occur anywhere in your body, including organs.  But all of this begs yet another question — what sort of “injury” or “insult” causes said fibrosis?

In his NIH bio, Wynn nibbles around the edges of this question by revealing that said “injuries” can occur in a variety of manner. “Fibrotic tissue remodeling is the final common pathological outcome of many chronic inflammatory and infectious diseases.”  In his scientific paper he goes on to spell it out in no uncertain terms. “Fibrosis is the end result of chronic inflammatory reactions induced by a variety of stimuli including persistent infections, autoimmune reactions, allergic responses, chemical insults, radiation, and tissue injury“.  In other words, his list covers the brunt of the THREE BULLET POINTS I dealt with recently.  Of these, the easiest to control comes from the “chemical insults“.  The truth is, the average American is chemically insulting their body on an almost hourly basis via the garbage we continue shoving into our collective pie holes — especially this time of year as the HOLIDAY SEASON is upon us.

The secret to stopping fibrosis is stopping inflammation.  Wynn tells us why in his NIH bio.  “When the wound-healing response is well organized and controlled, the inflammatory response resolves quickly, and normal tissue architecture is restored. However, if the wound-healing response is chronic or becomes dysregulated, it can lead to the development of pathological fibrosis or scarring, impairing normal tissue function and ultimately leading to organ failure and death.”   Death? Because the first step in “Death by Fibrosis” is the creation of an inflammatory response, the next question that needs answered is…..

WHAT IS INFLAMMATION?

Although inflammation is most typically associated by the general public with swelling, it’s important to realize that swelling is only a tiny fraction of what inflammation does (the myriad of chemicals we refer to as inflammation do have the ability to attract fluid to them and cause swelling).  Inflammation is the collective name given to the huge number of chemical messengers involved in cell’s ability to communicate with each other — frequently due to the fact that tissue has been damaged.  According to the Internet’s pinnacle of knowledge, Wikipedia, inflammation is defined as, “the complex biological response of body tissues to harmful stimuli, such as pathogens, damaged cells, or irritants, and is a protective response involving immune cells, blood vessels, and molecular mediators. The function of inflammation is to eliminate the initial cause of cell injury, clear out necrotic cells and tissues damaged from the original insult and the inflammatory process, and to initiate tissue repair.”  In the opening paragraph of his scientific article, Wynn mentions a slew of chemical compounds that make up inflammation, most of which I listed for you several years ago (HERE).  And here’s the rub.

Inflammation is difficult to address properly because it is needed for your body’s normal, everyday, healing processes (“synthesis of extracellular matrix components like collagen is an indispensable and, typically, reversible part of all wound-healing responses“), but these processes can, and often do go plumb haywire (“normal tissue repair can evolve into a progressively irreversible fibrotic response if the tissue injury is severe or repetitive or if the wound-healing response itself becomes dysregulated“).  Which brings us to still another question; how does the healing process get derailed to the point where it becomes pathological?  Much of it revolves around the fact that everything you do is either driving or squelching normal FIBROBLASTIC ACTIVITY within the body.

WHEN INFLAMMATION BECOMES A PATHOLOGICAL PROCESS
CAN FIBROSIS BE REVERSED?

Inflammation is kind of like Granny Clampet’s “Rheumatism Medicine”.  While a little bit will take care of just about whatever ails you (HERE), cross the line and things can get really crazy, really fast. “Fibrosis occurs when the synthesis of new collagen by myofibroblasts exceeds the rate at which it is degraded, such that the total amount of collagen increases over time.  most chronic fibrotic disorders have in common a persistent irritant that sustains the production of growth factors, proteolytic enzymes, angiogenic factors and fibrogenic cytokines [inflammation], which stimulate the deposition of connective tissue elements that progressively remodel and destroy normal tissue architecture.” Destroying the structure of cells would naturally destroy their function, and vise versa. Thus, the next obvious question is whether or not fibrosis can be reversed?

Because a pathological fibrotic process is, at least in most cases, a normal healing process gone out of control, stopping it can prove difficult. Everything that might be driving the process of inflammation must be addressed. But clicking the link shows that the medical community is, BY AND LARGE, not interested in dealing with inflammation’s number one cause — poor diets. They are far more interested in dealing with inflammation via drugs, or via some sort of yet-to-be-discovered drug that can break down Scar Tissue, while leaving the healthy tissue untouched. Unfortunately, Dr. Wynn reveals in his NIH bio that so far, this has proved to be a pipe dream. “Few—if any—treatment strategies specifically target the mechanisms of fibrosis. So what has the medical community done? They’ve simply moved upstream from dealing with fibrosis to deal with the cause of fibrosis — inflammation. The conundrum here is similar to that seen in fibrosis — that inflammation is a vital part of normal immune system function and intercellular communication, as well as being intimately involved in your body’s minute-by-minute healing processes.

Don’t get me wrong; suppressing various inflammation pathways is often quite effective — at least as far as short term symptomatic relief is concerned (NSAIDS for instance). The problem is that the drugs that do this best have side effects that are often MUCH WORSE AND MUCH MORE FREQUENT than we have been led to believe by our doctors or the TV COMMERCIALS we all seem to trust so much. These drugs have an accumulative effect on the various cells, organs, and tissues in the body (particularly the heart, kidneys, and liver). And when we move up to the heavy-hitters that actually suppress the immune system itself, things have the potential to get downright ugly.

These “uglier” drugs include CORTICOSTEROIDS and the recycled chemotherapy drugs from the 1960’s (TNF-α Inhibitors) whose generic names end with “mab” such as Humira or Remicade, or etanercept (Enbrel). I would never argue that this class of drugs does not work; they often work like magic. Just understand that their side effect profile can be rather severe due to the fact they are strenuously and aggressively suppressing one’s own immune system (Solomon’s study in Arthritis and Rhematology stated that, “there is concern that therapy with TNF inhibitors might predispose patients to adverse effects related to impaired immunity, including an increased incidence of infections and/or cancer.” Here’s my simplest take on the whole mess.

If you haven’t already done it, change the way you eat. But please hear what I am saying. The point is not to suggest that AN ANTI-INFLAMMATORY DIET is going to solve all cases of fibrosis. It’s to let you know that because it has the potential to dramatically aid most of you who try it in one way or another (it’s the lowest of the low-hanging fruit), it’s never a bad option for whatever ails you. But remember; diet is not the only way to get inflammation under control — not by a long shot.

I’ve shown you SOME OF THE MIRACLES that can occur when people with chronic diseases and autoimmunity realize that they can actually start blocking the process of fibrosis by inhibiting inflammation at its source(s) (HERE). The end result is that they not only feel better, their body starts to work more like it should again. And while it might be tough (even impossible) to reverse fibrosis in say the heart, it is much easier to reverse the process in the musculoskeletal system. Because so many painful conditions have FIBROTIC FASCIA or FIBROTIC TENDONS as part of their pathology, dealing with them IN A MECHANICAL FASHION can often prove EXTREMELY EFFECTIVE. Part of this is because as opposed to organs, they are usually SUPERFICIAL ENOUGH to be accessible enough to treat.

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