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I have felt for some time that both orthodox and complementary practitioners get too hung up on disease names. The more I learn about chronic inflammation (see Table I) the more this opinion is reinforced.

In order to avoid 'not seeing the wood for the trees', perhaps we should disregard the names of the diseases and just learn more about the processes of inflammation? This has certainly helped my understanding of how to treat people with these conditions.

Causes of Inflammation

Inflammation begins with a trigger of some kind – anything which brings white blood cells known as macrophages to the scene.

Macrophages are attracted by proteins and other particles which 'should not be there'. For instance:

* Microorganisms • Cell debris from injuries or from toxic insult • Leakage from capillaries into surrounding tissues • Partly undigested food particles • Cells which look abnormal (e.g. cancer cells).

Macrophages produce cytokines – chemical messengers which stimulate the production of enzymes to 'clean up' these waste proteins.

One of these enzymes is collagenase (literally, 'collagen-destroying enzyme'). Unfortunately collagenase is not able to discriminate between unwanted proteins in the area and your own connective tissue, such as the collagen in your joint cartilage.

To aid the 'clean-up' process, much heat may be generated in the affected area(s). Swelling usually occurs; this means that histamine is being produced to make blood capillaries more 'leaky'. Leaky capillaries will release extra fluid into the area, and this fluid helps large numbers of white blood cells to swim quickly to the scene.

Swelling in sensitive areas causes tenderness and pain, as anyone knows who has sustained a ligament injury.

Chronic Triggers

Inflammation should cease when macrophages have completed their task. So if inflammation becomes chronic, this strongly suggests that some kind of trigger is constantly present. Table II considers potential candidates.

Damage from the destructive enzymes of inflammation is soon repaired after a one-off injury or infection. But with chronic inflammation, the longer it continues, the greater the risk of tissue destruction. For example in osteoarthritis, cartilage is eaten away until bone rubs on bone. In rheumatoid arthritis, scar tissue takes the place of cartilage, and bones fuse together. Similar processes occur in gum disease, coeliac disease, kidney disease, Crohn's disease, multiple sclerosis and emphysema.

Fibrosis, or a hardening of the area, may also result from long-term inflammation. This impedes lymphatic drainage, and can worsen and prolong any inflammatory damage.

Orthodox Treatments

Orthodox medicine treats inflammatory diseases with two major categories of medication:

* Non-steroidal anti-inflammatories (NSAIDS), e.g. aspirin, paracetamol, ibuprofen • Steroidal anti-inflammatories (mainly cortisone-based).

NSAIDs work by temporarily inhibiting the production of some (but not all) cytokines and inflammatory prostaglandins. Cortisone works by temporarily suppressing the immune system. Neither of these treatments are cures.

Natural Treatments are Based On

* Reducing pro-inflammatory foods • Anti-inflammatory, restorative foods and supplements • Intestinal cleansing and deep tissue cleansing routines • Massage and manipulation to encourage good circulation and lymphatic drainage • Natural pain-killers.

Pro-Inflammatory Foods

* Diuretic drinks: tea, coffee, alcohol, due to their dehydrating effect • Excess salt (raises histamine) • Meat and dairy products. These are the only food sources of arachidonic acid. Avoiding food sources of arachidonic acid achieves exactly the same purpose as the new COX-2 inhibitor drugs used to treat arthritis. The COX-2 enzyme makes inflammatory prostaglandins from arachidonic acid • Food intolerances (e.g. wheat, dairy products) are a major cause of inflammation.

Anti-Inflammatory Foods

* Water • Black, blue and purple fruits • Celery juice • Oily fish (herrings, salmon, pilchards etc.) • Turmeric

Anti-Inflammatory Supplements

* Extracts of nettle and ginger: block cytokines • Fish oil: reduces formation of arachidonic acid from dietary fats • Evening primrose oil: contains GLA which blocks cytokines • Vitamin C (1-10 grams/day) and quercetin: reduce histamine • Celery seed extract: reduces acidity which promotes inflammation • Bromelain: reduces inflammation and fibrosis • Glucosamine sulphate: helps to inhibit cartilage-destroying enzymes.

Natural Pain-Killers

* Devil's claw herb • DL-phenylalanine (DLPA) – an amino acid.

The scientific references for this article are too numerous to include here, but can be found in Linda Lazarides' book, Treat Yourself with Nutritional Therapy (Waterfall, ISBN 0953804631, 2000).