DIAGNOSING RHEUMATOID ARTHRITIS: PHYSICAL EXAMINATIONAfter the clinical history is taken, the physician will perform a physical examination. Your physician will examine all of your joints, looking for evidence of tenderness, heat, swelling, and decreased motion. Your doctor will pay particular attention to the pattern of joint involvement because one of the distinguishing characteristics of RA is the particular pattern of joints that can be affected. Often the physician will perform a complete physical examination (including taking your blood pressure; feeling your glands; examining your eyes, ears, nose, throat, and skin; listening to your heart and lungs; examining your abdomen; and checking your reflexes and muscle strength) to uncover clues to help him or her identify the type of arthritis you have.Sometimes, in the early stages of RA, people find the results of the physical examination frustrating because they are experiencing significant pain or stiffness in their joints, and the physician may not be able to detect outward signs of joint inflammation. In these cases the physician has to proceed on the basis of the patient’s description of the pain or stiffness he or she is experiencing. Again, the accuracy of the clinical history provided to the physician is extremely important.*16/209/5*

It is a common observation that many people afflicted with arthritis have a long record of chronic constipation preceding the onset of the disease.

Constipation is the root of many evils. It causes great discomfort and can be a contributing or major cause of a great many diseases. It may lead to such disorders as hemorrhoids, varicose veins, hernia, upset digestion, nervous irritability, skin eruptions, eczema, muddy complexion, and headaches. “Bad breath”—a national disgrace on which mouthwash manufacturers are now making millions of dollars—is more often than not a direct result of constipation. (Needless to say, no mouthwash can correct bad breath caused by constipation, since foul odor comes from the stomach and the lungs, not from the mouth!)

But constipation can also lead to many more serious diseases, such as impaired function of liver, gall bladder, kidneys, and other vital organs, and can be one of the major contributing causes of arthritis.

Your intestines house billions of different bacteria which help your digestive system break down the food you eat and thus aid their housing organism in its metabolic processes. Some of these are what we call “friendly bacteria,” some are “unfriendly” or putrefactive bacteria. When the diet is unbalanced, as in the case of too much refined and overcooked carbohydrates and too much animal protein, the balance of the intestinal flora is disturbed, harmful bacteria take over, and the result is sluggish bowels, gas, putrefaction, and constipation. Toxins (poisons) created by bacterial metabolism and putrefaction remain in the intestines and, as a result of prolonged constipation, are absorbed by the bloodstream, poisoning the whole organism. Chronic constipation will eventually weaken the muscles of the large intestine so that they will not be able to function properly and expel waste matter from the colon. Chronically constipated and sluggish intestines lead to chronic autointoxication or self-poisoning.

As was pointed out in Chapter 6, the impaired elimination of metabolic wastes and toxins from the system, and resultant autointoxication, is one of the most prominent syndromes or characteristics of arthritis. Therefore, those afflicted with arthritis should make a special effort to overcome constipation— this largely ignored and neglected but very dangerous ailment. Even if you do not suffer from arthritis as yet, but are badly constipated, make sure you correct this trouble before it leads to more serious complications.

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