Caters' bone digestion and Kepler B appendix threads merged

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Which treatment is more reasonable for appendicitis?

Appendectomy to prevent appendicitis from reoccurring
1
50%
Appendix drainage via colonoscopy to prevent rupture
1
50%
 
Total votes : 2

Caters' bone digestion and Kepler B appendix threads merged

Postby caters on August 2nd, 2017, 11:54 am 

My Kepler Bb humanoids have lots of similarities to us and lots of differences too. Here are some of those differences:

  • Extra intracranial space so that the brain can swell from illness without injuring itself
  • Appendix actively participates in digestion by breaking cellulose down into simple sugars that are then absorbed into the blood(so longer appendix)
  • 2 hearts and circulatory systems, 1 of which is inverted
  • 2 sets of ovaries in females
Now, there is a virus that can be transmitted in every way possible, is completely antiviral resistant, and can infect every part of the body. That virus causes a severe and sometimes even deadly illness known as Viral TB. Viral because a virus infects the cells and TB because it can infect every part of the body and granulomas regularly form and go away(latent and active phases respectively).

This can be a serious problem if the virus infects the appendix causing appendicitis.

Appendicitis caused by Viral TB actually has 2 stages that are determined by the phase of the virus in the appendix.

The first stage of appendicitis is actually pretty mild. Swelling occurs but blood supply stays normal for the appendix. This also corresponds with colitis and proctitis in the timing(colitis at the same time as appendicitis, proctitis a bit later than appendicitis. This is when the virus is in the active phase in the appendix.

But later on when the immune system traps the virus in granulomas, it is quite different. At this point the appendix is blocked by granulomas which leads to a much more severe stage of appendicitis and even a ruptured appendix.

Because the appendix is blocked the mucus and gut flora can't get to the colon and food with cellulose can't get to the appendix. The appendicular artery starts to get pinched by the appendix and this is when classic symptoms of appendicitis appear such as RLQ pain. As the appendicular artery gets pinched, the appendix starts to die. Not a good thing. But it gets worse. As the appendix dies, the wall weakens and eventually it ruptures causing an infection throughout the abdomen. All from an organ the width of a finger.

Because it is caused by a virus, antibiotics won't work. And antivirals won't work because the virus is completely resistant to them. So there are really only 2 options here.

Option 1: Appendectomy

1 option is to have the appendix removed either via open surgery or laproscopically. This will prevent the humanoid from ever getting appendicitis again but with the cost of not getting as much energy from food as previously(which would be bad news for vegetarians)

Option 2: Drainage via colonoscopy

The other option is to have a drain put into the appendix via colonoscopy so that mucus and gut flora can go from the inflamed appendix to the colon. Again, this means that the humanoid would not get as much energy from food but this is only a cost during the appendicitis. After it is over, the drain is taken out of the appendix via colonoscopy and the appendix can participate in digesting food again. But this has the risk of reoccurring appendicitis.

So I was thinking that appendectomy should only be a last resort given the importance of the appendix and should only be done if the appendix ruptures. So appendix drainage via colonoscopy would be the preferred way to go about treating any appendicitis really and the drain would be in there for a few days or weeks if the appendicitis isn't caused by Viral TB and months to years if it is.

But is it reasonable to put a drain into the appendix in humanoids with appendicitis to prevent rupture of the appendix due to its role in digestion or should everyone, including vegetarians get an appendectomy and just eat more food to compensate for a removed appendix?
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Re: How should appendicitis be treated?

Postby Braininvat on August 2nd, 2017, 12:29 pm 

Note to self:

Do not read Caters' recent postings while eating or snacking. :-)

The appendix is a vestigial caecum, and isn't much use to an omnivore. Last I had heard, it's functional role in digestion is so minimal that saving it doesn't really have significant effect on digestion of plant materials. NASA used to recommend appendectomies for astronauts before long missions into space. Don't know if that is still the case.
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Re: How should appendicitis be treated?

Postby BadgerJelly on August 2nd, 2017, 12:32 pm 

Eat more food? Exactly how much more food do you think this involves? Please provide evidence.
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Re: How should appendicitis be treated?

Postby caters on August 2nd, 2017, 12:46 pm 

Well like I said, this is for my Kepler Bb humanoids, a fictional species that I made to essentially be Human Version 2.0.

And the virus again is a fictional virus that basically tests the fate of these humanoids.

Of all the organ systems, here are the ones that actually have differences in anatomy:

Female Reproductive(2nd set of ovaries)
Circulatory(2 hearts and circulatory systems and 2 sets of coronary arteries per heart)
Immune system(Antibodies produced against venom and poison)
Digestive(2nd stomach for passive chemical digestion of bone and longer appendix to digest cellulose)
Endocrine(Extra gland that produces a protein storage hormone and a protein usage hormone)
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Re: How should appendicitis be treated?

Postby doogles on August 2nd, 2017, 5:51 pm 

My appendix has never been a problem but I had my humanoids successfully removed about forty years ago.
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Bone Digestion

Postby caters on August 14th, 2017, 7:32 pm 

My Kepler Bb humanoids have a digestive system that is similar to ours but also in 2 anatomical ways, different.

The 1 anatomical difference that gives these humanoids more energy is, wait for it, their appendix.

Image

Now this is a normal human appendix, only a few inches long. But a Kepler Bb humanoid's appendix is at least 3 times as long. With this added length, more good bacteria can be safely tucked away when the humanoid is ill and cellulose can be digested into simple sugars and absorbed into the bloodstream. This coupled with an overall higher BMR(basal metabolic rate) means that they get more energy from the same kinds of food than we do, particularly from plants.

Now their other anatomical difference related to digestion is that they have 2 stomachs, 1 of which is just like ours and the other being inverted along the L->R axis.

Humanoid Stomach.png


As you can see here, the gastric sphincter between the 2 stomachs is right in the middle of the first stomach. Now most of the time, food just gets digested in the first stomach both mechanically and chemically. But there are 3 cases in which the gastric sphincter will open and food will go into the second stomach. 1 of those is gluttony in which the gastric sphincter will stay open until there is a more comfortable amount in the first stomach. The other is illness during which any food that is eaten will go into the second stomach with as little time in the first stomach as possible to avoid vomiting up food. In fact both of these cases are to avoid vomiting up food. But there is 1 other case that is more interesting. Digestion of bone.
 
You see, these humanoids eat a lot of bone, especially when they are either children going through growth spurts or pregnant women. Now the lower age limit for eating bone is 5 years and it is that way for a good reason. Any younger than 5 years and the esophagus will literally be scraped to the point of bleeding by eating bone. If this happens, a lot of blood can get into the first stomach and the child will vomit the blood back up. This can aggravate the esophageal scrape and thus worsen the bleeding which leads to more vomiting. While yes, with rehydration therapy the bone will get digested and the esophagus will heal, the child can easily become anemic this way. And yes bone marrow has a high iron content so the anemia would easily be corrected. But it is just not worth it to eat bone when the humanoid is below 5 years old. An anemic humanoid below 5 would be better off eating liver than bone to correct their low iron because then at least there won't be bleeding and vomiting.

Anyway, the digestion of bone in the second stomach is very slow. Even with the bone digesting enzymes it secretes, it can still take hours to digest the amount of bone in an average meal depending on how thick the bone is. The meat itself, the muscle is digested much faster than this. And even though a higher amount of stomach acid speeds up the process, it doesn't speed it up by all that much. Once the bone has been digested, the gastric sphincter opens to let the second stomach push the digested bone into the first stomach to let it out into the intestines via the pyloric sphincter.
 
But I was wondering, is there a better way to digest bone without risking bleeding in the intestines and while still having the defense against vomiting food provided by the second stomach being in the position that it is? Could anything other than enzymes and amount of stomach acid speed up the process?
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