Inflammation: So many causes, only one mechanism

It is a process that can affect any part of the body and for very different causes, but the basic events are always the same. Arthritis, gastritis, myositis, bursitis, stomatitis, conjunctivitis, colitis, pharyngitis, tendonitis, gingivitis, appendicitis, otitis, cystitis, and more … The names are many, practically one for each organ or tissue, but the meaning is all contained in that small suffix, which indicates inflammation.

That is, burning, redness, swelling and, above all, pain. Symptoms experienced by everyone since childhood, for the most diverse reasons, which tend to change in part with advancing age.

The causes point by point

Inflammations of the musculoskeletal system, for example, may arise due to trauma due to a stroke or fall, or due to damage to a muscle or joint caused by over-intense or prolonged use, or due to of an improper position maintained for a long time, of a sudden movement or of a local chronic inflammatory pathology (such as knee bursitis) or generalized (rheumatoid arthritis, gout, etc.).

Skin and mucous membranes can be inflamed, however, by reaction to an external wound or an internal injury (such as an ache in the mouth or a stomach ulcer) or the inflammation can develop as a result of sensitization or irritation caused by specific substances, external, but also internal (as occurs in the irritation of the stomach and esophagus when suffering from gastric acidity).

Further inflammatory phenomena derive from the aggression of tissues by external pathogens such as bacteria and viruses ( colds, flu, pharyngitis, tonsillitis, laryngitis, bronchitis, cystitis, otitis, etc.).

Particularly painful and often difficult to treat inflammations concern the nerves. In these cases, in addition to direct damage fortunately rare, can be excessive stimulation occasional (this is the case of trigeminal neuralgia triggered by intense cold or dental sensitivity) or chronic changes in the tissues surrounding the nerve and that tend to modify the functionality and to promote degeneration (as in diabetic neuropathy).

Besides the localized ones, there are also the inflammation extended to the whole organism (called systemic ones), which can be induced by the immune reaction stimulated by an infection (such as flu and hepatitis) or by an allergy or from an autoimmune reaction, that is against components of our own organism, linked to well-defined pathologies (such as rheumatoid arthritis, psoriasis, systemic lupus erythematosus and so on).


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The basic mechanism is the same

Although the events that can trigger an inflammatory reaction are multiple, the mechanism is only one: the activation of two specific enzymes called cyclooxygenases (Cox 1 and Cox 2), present almost everywhere in the body, and the consequent release of prostaglandins.

Prostaglandins are substances characterized by a strong pro-inflammatory action, that is, they induce a series of events, which are at the base of the inflammatory process.

One of the first phenomena that is observed is the redness and swelling of the area affected by inflammation, this is because of the release of substances that cause vasodilatation and increase the vascular permeability. This is why in a few moments the affected area appears warmer, swollen and reddened.

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Inflammatory pain is typically acute and burning (burning). If it affects a muscle or an articulation it may be dull and constant at rest, but it will inevitably increase with movement, often preventing the affected part from being used for one or more days.

When it is borne by a mucosa, it can remain as constant discomfort that worsens with contact or with the use of the inflamed part (typical of pharyngitis, gastritis, etc.) or presenting an oscillating “colico” with alternation of “thick” and moments of relative respite (this is the case of colic, of any nature).

Sometimes it can be precious

Although annoying, inflammation is useful in many cases: it warns us that somewhere in our body there is something wrong or that a trauma has caused non-trivial damage to which it is necessary to remedy. Furthermore, it induces us not to further urge the painful area and stay at rest, placing us in the ideal conditions to promote healing.

Other times, however, the inflammatory reaction is completely useless or even harmful. It happens, for example, when it occurs spontaneously due to an allergic or autoimmune disease.

Symptoms must be treated

Whatever the reason that causes it, inflammation can and must be cured, at least in part. First of all not to suffer too much, but also to prevent its persistence causing secondary damage to the tissues. To do this we can use a large group of anti-inflammatory drugs, able to counteract the production of prostaglandins through the direct inhibition of cyclooxygenases.

There are many, even self-medication (OTC), and in various formulations to choose according to the type of inflammation (local or systemic), the intensity of the symptoms, the possible presence of wounds and the acute or chronic origin of the disorder.

The most commonly used drugs are non-steroidal anti-inflammatory drugs, such as acetyl-salicylic acid, naproxen sodium, diclofenac or ibuprofen that we can find in different formulations to be chosen according to needs, keeping in mind the type of trauma and especially the affected area.

When inflammation affects a limb or a localized area it is possible to opt for a topical formulation, in cream or gel, to spread directly on the part. This allows a more localized action and also reduces the risk of side effects, because the absorption at the systemic level is very low.

However, if the pain is more intense and the part to be treated is wider, it is preferable to take oral medications, also in this case you can choose among many options, swallowable tablets, effervescent tablets, orsoluble, sachets to be dissolved in water.

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