Idiopathic inflammatory diseases have increased dramatically in recent years. The word idiopathic literally means we are “idiots as to the cause”. These disease states include virtually every organ system and include many types of arthritis, fibromyalgia, migraines, sinusitis, asthma, allergies, reflux, irritable bowel syndrome, chronic fatigue syndrome and I am sure many forms of depression.

We as physicians are taught to rule out any thing ominous, such as a tumor, mass, lesion, stroke or infection. Beyond that we don’t have much to offer. Most of these ailments respond dramatically to anti-inflammatory agents such as corticosteroids, however after a time we get a bit excited about the side affects of these medications as well.

In reality, what steroid do is to shut down our over active immune system. Thus, it seems reasonable to postulate that in reality we are creating the majority of our own problems with our aberrant immune response. That is, these previously mentions pathologic conditions are really autoimmunities, allergies,or hyper-responses to rather routine infectious agents. We are in fact over reacting and fighting our own tissues or reacting against antigens in our environment that most folks don’t. This chronic inflammatory state is being recognized more and more across medical specialties as a primary etiology for disease. Take for example coronary and carotid artery disease. Indicators of chronic inflammation possess far more correlation with the disease state than do cholesterol levels. We have just finally admitted that asthma is a chronic inflammatory disease state rather than a reactive “twitchy” airway issue where steroids should be avoided, and we are finally realizing that infection is more a result of rather than a cause of chronic rhino sinusitis.

As the etiology or cause of the inflammation is multifactorial, so must be the treatment. Nutrition, anti-inflammatory such as corticosteroids, avoidance of offending agents, and desensitization all play a role. We weren’t taught a lot about these conditions in medical school, so just recognizing them is the first step. We must also critically review the available literature and avoid anectodal evidence. For a critical view visit

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