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Medical Forum / General / General / November 2004

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Why dont we die of bleeding piles ?

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habshi - 06 Nov 2004 19:55 GMT
    There is blood and lot of bugs eg E Coli around and yet we
dont get blood infection and die from it . Why ? Does the local gut
produce antibiotics or antiseptics and can we purify them ?
    Heroin addicts inject with contaminated needles and soon die
-( all drug suppliers should be charged with attempted murder of
persons unknown when caught )
tech27 - 06 Nov 2004 20:17 GMT
> There is blood and lot of bugs eg E Coli around and yet we
> dont get blood infection and die from it . Why ? Does the local gut
> produce antibiotics or antiseptics and can we purify them ?
> Heroin addicts inject with contaminated needles and soon die
> -( all drug suppliers should be charged with attempted murder of
> persons unknown when caught )

Hardly. It would be easy to argue that they don't want to kill the users,
rather keep them around to make money.

However, I WOULD support legislation requiring all addicts to carry a "DO
NOT RESUSCITATE" card.
Jeff - 06 Nov 2004 21:05 GMT
> There is blood and lot of bugs eg E Coli around and yet we
> dont get blood infection and die from it . Why ? Does the local gut
> produce antibiotics or antiseptics and can we purify them ?
> Heroin addicts inject with contaminated needles and soon die
> -( all drug suppliers should be charged with attempted murder of
> persons unknown when caught )

There are a lot of immune cells and lymph tissue around the intestines and
in the intestinal walls.

Jeff
habshi - 07 Nov 2004 01:20 GMT
    Maybe , but in bleeding piles the bugs have direct access to
the blood and patients should be dying of bacteriaemia and sepsis but
they dont . Why not ?

There are a lot of immune cells and lymph tissue around the intestines
and
in the intestinal walls.

Jeff
Jeff - 07 Nov 2004 03:31 GMT
> Maybe , but in bleeding piles the bugs have direct access to
> the blood and patients should be dying of bacteriaemia and sepsis but
> they dont . Why not ?

When  people get a cut in their skin, the bugs have direct access to the
blood, and patients should be dying of bacteriaemia and sepsis, but they
don't.

Why? Because people have an immune system. The blood is filtered by the
spleen and the liver (the liver has immune cells called "Kuppfer" cells that
are macophages, white blood cells that eat up bacteria). The blood sends in
white blood cells to fight any infection that may arise.  This applies to
anywhere in the body where there is cut or infection.

The intestines, especially the large intestine has a rich supply of blood.
The blood supply means that white blood cells can go anywhere bacteria
invade. In addition, large intestine has Peyer's patches, which are like
lymph nodes in the intestinal wall. Plus, the Kuppfer cells in the liver get
the bacteria before they can enter the circulation outside the GI tract
(almost all of the blood that comes from the GI tract enters the portal
circulation and goes through the liver before it goes into the general
circulation -- I think only blood from the mouth, throat and some parts of
the rectum is drained through the circulation that does not enter the portal
system and instead goes right into the general circulation).

In fact, rectal surgery, like for hemorroids is relatively free of post op
infections, something you might not expect consider that all of the poop
with lots of bacteria exit through the rectum.  And other conditions that
are associated with bleeding, like anal tears and polyps, also have a very
low rate of infection, because of the blood supply and rich amount of immune
cells ready to fight infection.

If you need more information, I think there is a great site for you:
www.google.com. Enter  intestine + immune system to learn more. They will
give you the straight poop on why bacteria in poop doesn't cause as many
infections are you might think.

Jeff
habshi - 07 Nov 2004 12:45 GMT
    OK but does the anal area produce antibiotics as well ?
Jeff - 07 Nov 2004 14:44 GMT
> OK but does the anal area produce antibiotics as well ?

No. Antibiotics are not produced by the body (including the anal area). They
are produced by fungi in factories and in the wild. Besides, antibiotics
wouldn't work, because the bacteria would become resistant.

Jeff
habshi - 07 Nov 2004 20:17 GMT
    People get sepsis  infected blood sores or cuts which remain
bleeding for a long time . However blddeing piles can go on forever
without getting infected
Bob - 08 Nov 2004 02:11 GMT
>> OK but does the anal area produce antibiotics as well ?
>
>No. Antibiotics are not produced by the body (including the anal area). They
>are produced by fungi in factories and in the wild. Besides, antibiotics
>wouldn't work, because the bacteria would become resistant.

Actually, (natural) production of antibiotics by animals is an
interesting and developing subject. There is even possible interest in
commercial development of frog skin antibiotics.

The following article is on peptide antibiotics from human skin:
K Midorikawa et al, Infect Immun 71:3730, 2003. It is probaly now
available freely at www.asm.org

Also:
Antimicrobial peptides of multicellular organisms
M ZASLOFF
Nature 415:389, 1/24/02. Review.

I do not know whether such antibiotics are found in the anal area, but
unless someone knows of data, I'd suggest it be left as an open
question.

As to resistance... Look, there are all sorts of evolving balanced
relationships in nature. So the possibility of resistace is not an
argument against it. I also vaguely recall that there is some thought
that resistance to some of these peptide antibiotics may be unlikely,
since they seem to have a fairly general mode of action, of damaging
prokaryotic membranes. Whether that would hold up if pushed remains to
be seen.

There is a traditional definition of antibiotics that defines them as
products of microbes (bacteria and fungi), but I assume there was no
intent here to use that restriction.

bob
Leonard Martin - 11 Nov 2004 05:38 GMT
> > Maybe , but in bleeding piles the bugs have direct access to
> > the blood and patients should be dying of bacteriaemia and sepsis but
[quoted text clipped - 34 lines]
>
> Jeff

Boy, that was great! I've wondered about this question for years
(exactly as long as I've had bleeding piles, to be precise).

Leonard

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