Pressure Drill DownI have been challenged. A friendly acquaintance told me he doubted that the pancreas would be pressured by fat because the skin is so malleable. He was apparently unaware that visceral fat is not between muscle and skin, but rather between internal organs and abdominal muscles. He was talking about guys who had to be moved on pallets, though, so he was talking about visceral fat. His point would have been that abdominal muscles are malleable, too.
I was thinking that abdominal muscles may expand, but they do provide more inward pressure than skin. Secondly, the rib cage is bone and cartilage. It surely has an expansionary limit. So my first drill down was to locate the duodenum / pancreas vis a vis the rib cage. Check out this absolutely gorgeous graphic of the stomach and duodenum in a chest. The stomach is mostly in the rib cage. The duodenum is right where the rib cage ends. It seems that the pressure theory is still on.
Next I went looking for what affect a fetus has on the internal organs, whether it puts pressure on them. All I could find was a doctor saying that it's like putting a meatball in spaghetti; the spaghetti just slithers out of the way. I was thinking that this only applied if there was room in the pot for the meatball. What if the pot was full and you put in a huge meatball, then shoved the lid back on? Wouldn't that lid put pressure on the whole works? ... But if we just go with the meatball analogy, the pressure theory looks less likely. (Although, wait a minute, it says here the internal organs are under pressure in pregnancy.)
Then I found this quote regarding visceral fat and its effects on internal organs, "Many organs, including the stomach are forced into abnormal positions and sizes." Pressure is put on the lungs as well. I was back in the game. (Although I am not proposing that the stomach is extremely out of whack in diabetics, the stomach can and does go far out of position.)
Along the way, I decided to research just how it is the duodenum is attached to the greater structure of the body. I hit pay dirt. The duodenum is attached to the posterior abdominal wall in 3 places. It is also attached via a suspensory ligament, the ligament of treitz, near where it attaches to the jejunem. I infer that every place the duodenum changes angles, it is attached somewhere. The duodenum is commonly referred to as having a "C" shape. I propose that because of this suspensory ligament, it has a "G" shape.
What this means to the pressure theory is that the pressure does not work via compression, but rather via strangulation. The stomach is shoved over, the suspensory ligament stays put, the noose tightens. Because most of the duodenum is attached to the posterior abdominal wall, and the ligament of treitz is not, I propose that the duodenum twists as well as cinches. I bet you the arteries between the duodenum and pancreas love that.
The abdominal attachments of the duodenum explain explain the "sproing" that occurs when the duodenum is cut free from the stomach. It also provides somewhat of a dilemma if the pressure theory is correct and diabetes can be resolved by inserting a section of pipe right at the stomach/duodenum juncture, after the valve, of course. What happens if the patient, free now (we hope) from diabetes, loses weight? The stomach is going to want to move back over to its previous position near the pancreas. What problems will arise from that? Will the artificial section of duodenum kink and lodge food? The researchers will have to keep a close eye on that.
Next I went looking for what affect a fetus has on the internal organs, whether it puts pressure on them. All I could find was a doctor saying that it's like putting a meatball in spaghetti; the spaghetti just slithers out of the way. I was thinking that this only applied if there was room in the pot for the meatball. What if the pot was full and you put in a huge meatball, then shoved the lid back on? Wouldn't that lid put pressure on the whole works? ... But if we just go with the meatball analogy, the pressure theory looks less likely. (Although, wait a minute, it says here the internal organs are under pressure in pregnancy.)
Then I found this quote regarding visceral fat and its effects on internal organs, "Many organs, including the stomach are forced into abnormal positions and sizes." Pressure is put on the lungs as well. I was back in the game. (Although I am not proposing that the stomach is extremely out of whack in diabetics, the stomach can and does go far out of position.)Along the way, I decided to research just how it is the duodenum is attached to the greater structure of the body. I hit pay dirt. The duodenum is attached to the posterior abdominal wall in 3 places. It is also attached via a suspensory ligament, the ligament of treitz, near where it attaches to the jejunem. I infer that every place the duodenum changes angles, it is attached somewhere. The duodenum is commonly referred to as having a "C" shape. I propose that because of this suspensory ligament, it has a "G" shape.
What this means to the pressure theory is that the pressure does not work via compression, but rather via strangulation. The stomach is shoved over, the suspensory ligament stays put, the noose tightens. Because most of the duodenum is attached to the posterior abdominal wall, and the ligament of treitz is not, I propose that the duodenum twists as well as cinches. I bet you the arteries between the duodenum and pancreas love that.
The abdominal attachments of the duodenum explain explain the "sproing" that occurs when the duodenum is cut free from the stomach. It also provides somewhat of a dilemma if the pressure theory is correct and diabetes can be resolved by inserting a section of pipe right at the stomach/duodenum juncture, after the valve, of course. What happens if the patient, free now (we hope) from diabetes, loses weight? The stomach is going to want to move back over to its previous position near the pancreas. What problems will arise from that? Will the artificial section of duodenum kink and lodge food? The researchers will have to keep a close eye on that.
4 comments:
The theory seems logical to me, though I have no expertise in biological and medical matters. Maybe pressure on the pancreas or the blood vessels that go to the pancreas can cause diabetes, as you suggest. There could be other causes, too, of course. The "guts of the theory" section was repeated in your blog, maybe intentionally.
I had an "about this blog" section that told readers what was to follow, and that the larger essay was available in an easier-to-read Word file. I deleted it and moved the Guts entry up. The repeat of Guts is temporary.
hey,
I came across your blog and found it very interesting! I'm hoping to get your opinion on something.
Im 24, and have had "adult onset type I" diabetes since I was 18. I have pectus excavatum, and seem to have an extra rib, or displaced rib located underneath the bottom left side of my rib cage. It causes slight dull pain, and when I move it it sort of "pops"
I was wondering If you think this strange set up could interfere with pancreas function. Thanks for posting this stuff!
shaun.
Great to hear from you. My theory deals with Type 2 Diabetes. If Type 2 Diabetes is caused by a reduction in blood flow to the pancreas, perhaps a drastic reduction in blood flow is responsible for the total lack of insulin production in Type 1 Diabetes. How that would happen without pancreatitis also happening is mysterious to me. It is possible that your extra rib caused a cessation of blood flow to the B cells, or tweaked the pancreas somehow, but who knows if this actually is the cause. Maybe your B cells work just fine but the insulin isn't making it out of the pancreas somehow, due to the extra rib yanking or pushing something. Perhaps if someone spends the money to prove or debunk the blood flow theory for Type 2 Diabetes, and the theory is proved, then that will free up money to see if there is a blood flow component of adult onset Type 1 Diabetes. Have you been in contact with other people with extra ribs? Do any of them have adult onset Type 1 Diabetes? In any event, thank you for your interest.
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