device, called a laparoscope, is inserted through a small incision in the navel and the abdomen is examined and photographed or videoed. This procedure requires anaesthesia, but can be done in one day as an outpatient service. In the USA and Europe, some general practitioners can perform a mini-laparoscopy in their surgeries. As we will see in chapter 6, laparoscopy has the added advantage of allowing the consultant not only to diagnose the disease, but also to perform a simultaneous laser treatment, to ‘burn’ away visible endometriotic implants. If a woman consents to having a laparoscopic examination, she should confirm with the physician that in addition to diagnosing her disease, the endometriosis will be classified and photographed, and removed (by ablation, cauterization or laser). This spares her from a second operation and more anaesthetics, and the information will be very helpful in determining subsequent treatments. It would also prevent repeating the procedure if the patient changes doctors. Chapter 6 will discuss consent issues and medical ethics.
During laparoscopy, gases are pumped into the peritoneal cavity to increase the viewing area and to enable the consultant to move organs around in order to locate the endometriotic implants. Usually this form of surgery is successful in locating and ablating troublesome implants. The gases may dissipate to the four corners of the body, causing aching shoulders. Very occasionally the spine may need correcting by a chiropractitioner or osteopath as, when the body is tilted, unconscious, for several hours, the lumbar and cervical vertebrae may become misaligned. In order to speed up the healing of wounds after operations it has been shown that vitamin C and zinc supplements are helpful, as they are essential to the formation of collagen. Homeopathic Arnica 6X taken three days before and three days after an operation may reduce bruising. (Both Guy’s and St Thomas’s Hospitals in London, England, use this treatment for their patients after operations.)
CELLULAR BIOLOGY AND ENDOMETRIOSIS
Endometriosis happens at a cellular level; the implant attaches to the cell wall and hangs on for dear life. The important questions to ask are: Is something in the body weakening the cell membrane so that the endometriotic implants can take hold? How can we maintain the integrity of our cell membrane? If the cell membrane can remain strong, will it prevent the endometriotic implants from taking hold? Is a ‘balanced’ diet sufficient when we are so ill, or do we need nutritional supplements to help our bodies ‘kick start’ the healing process? Knowing how our cells work helps us understand why this may be essential in the short term.
Johannas Evers of Maastricht University in the Netherlands is ‘looking at the behaviour of endometrium and peritoneum, and at how the endometrial fragments contact the peritoneal lining, how it apposes and attaches to cell membranes. How it subsequently invades organs remains enigmatic’. Somehow, it is felt that these fragments of rogue tissue are damaging the peritoneal membrane. Evers has shown that normal peritoneal tissue has ‘Teflon’-like characteristics, which should be a defence against the endometriotic implants. But something secreted by the implants or immune cells may be disrupting this defence mechanism so that the peritoneal membrane behaves more like ‘Velcro’ and allows the endometriotic implants to stick fast to it.29
Research by Professor George Gray CBE has shown that cell membranes behave like liquid crystals. Liposomes (oils) give cell membranes integrity so that they act as a barrier to stop harmful chemicals from entering. Liquid crytals are rod-shaped molecules that are sensitive to light and heat. Local environmental conditions can affect the biology of these crytals. By increasing our knowledge of the dynamics involved, we can begin to understand why the cell membrane changes from ‘Teflon’ to ‘Velcro’.
Nutritionally we know that magnesium and essential fatty acids enhance cell membrane integrity.
CELL STRUCTURE AND FUNCTION
There are many different types of cell in the human body – sperm cells in semen, bone-forming cells, red and white blood cells, cells forming connective tissue to hold us together, cells secreting acid in the stomach to help us digest food, cells storing fat in adipose tissue so that we are ready to survive a famine or drought, and the germ cells which form the ova. The list is endless. The basic structure is the same, but the function is very different for each cell. Together, cells make up the body in which we live. Each type of cell relies upon the nutrients in our diet to be fully functional. Low levels of essential nutrients cause cellular function to begin to fail.
Our bodies are about 70 per cent water. The cells also contain many minerals, trace elements and vitamins, often linked with sugars, fats or proteins. You are made up from what you eat.
Figure 2.6
Cell diagram which shows all the major organelles within each cell. Rather like a small industrial centre, they take nutrients and process them to form new tissues and chemicals for our body to rebuild itself and stay healthy.
The basic cell structure (figure 2.6) consists of the outer layer or cell membrane, and the inner area which contains a fluid called cytoplasm. Within the latter are mini-organs rather like factories where proteins, fats, enzymes and hormones can be built. The centre of the cell contains the nucleus. This is the brain of the cell which controls how the cell behaves and how it will pass on its code to a new cell. The nucleus contains deoxyribonucleic acid (DNA), the genetically coded information that we have inherited from our parents. Cells chatter to one another and, if the message is disrupted, it becomes like a country trying to work without a postal service.
The cell membrane consists of phospholipids (compounds made up of cis-oils and phosphorus). In chapter 4, we look at the role of prostaglandins (which are oil-based hormones), and how the quality of the oils we eat is very important for fertility and pain reduction. The cis-fats found in natural oils can keep the cell membrane strong, whereas the trans-fats from manufactured or processed oils cannot lock into the membrane very well and leave the cell wall more likely to be breached by harmful substances. (Trans-fats may be made within the body or they could be from the environment.) The cell membrane is permeable, to allow nutrients and substances used for rebuilding the body cells to pass in and out.
A cell is rather like a little powerhouse, or production line. There are factories making proteins from amino acids, phospholipids from fats and oils, and glycoproteins from sugars and proteins. The structures called mitochondria take from your diet iron, vitamins C, Bl, B2, B3 and B5, magnesium and coenzyme Q10, and with glucose, water and oxygen make all the energy the body needs. Magical stuff goes on in the twinkling of an eye.
We know that the amount of magnesium in the body is important for the integrity of the cell membrane. Research has shown that magnesium on the cell membrane can prevent the changes that cause cancer. Research shows that: ‘Magnesium on the cell membrane helps cells stick together in a normal fashion. Magnesium is required in more than 30 enzyme systems that deal with cell growth and division, which are disordered in cancers.’30 Endometriosis cells appear to mimic the way cancer cells grow and this may be important to understanding the disease. Endometriosis is thought to have nothing to do with cancer, but the way in which the endometrial cells can implant themselves in other tissues and travel all over the body has some resemblance to the attachment and movement of cancers. By understanding more about the mechanism of transport, it may help us understand better how we can prevent the disease from taking hold. As magnesium is required for DNA replication and is involved with the enzymes affecting cell growth and division, we know that this mineral could be vital for reproduction and possibly for prevention of endometriotic implants. More research is necessary to show how magnesium levels affect the ability of endometriosis implants to attach to the cell membrane.
Production of skin, mucous membranes, cell membranes and tissue renewal are dependent on vitamins A, C and E, zinc, manganese, choline and essential oils (fatty acids). The mitochondria are protected by manganese and choline. Deficiency of manganese leads to alterations in cell tissues. So our nutrient intake can make the skin, mucous membranes and cell membranes throughout our body much stronger. Our bodies