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Issues With Tissues

How aging, surgery and disease affect your body's tissues 

Shoulder injuryLet's talk tissue. It's impressive stuff, with a lot of important jobs. It holds you together, gives birth to new blood cells and forms the organs that make life possible — and that's just to start.

But tissue can change as a result of disease, surgery and normal aging. Whatever the reason, changes in tissues alter how you function.

The impact of aging

Time takes a toll on tissues throughout your body, but the effects of aging may be especially notable in your skin, joints and heart.

Skin

Your skin is a collection of tissue. As you age, a number of changes occur:

  • Glands produce less oil and sweat. 
  • The skin's outer layer — the epidermis — gets thinner and less elastic.
  • The bond between the epidermis and the layer under it — the dermis — weakens.
  • The bottommost layer of skin, which contains connective tissue that attaches your dermis to muscles and bone, decreases. Over time, all of these changes can cause the skin to dry out, bruise, wrinkle and sag.

Take control: Smoking and sun exposure accelerate skin aging. Kicking a cigarette habit and wearing sunscreen are two of the most important things you can do to protect your skin.

Did you know? Exercise is good for your skin. It increases blood flow and may even strengthen your immune system. This can help your skin appear younger.

Joints

Aches and pains often increase in joints as the body grows older. Many times, that's due to osteoarthritis, the wearing away of cartilage (connective tissue) that cushions the ends of bones.

Aging plays a role in cartilage degeneration, though exactly how is unclear. It may be related to declining hormone levels, a stress response that promotes inflammation or a decrease in the number of cells that form cartilage.

One thing that's clear is that as we age, water content in the body decreases. As a result, tendons (bands of tissue that attach muscle to bone) and ligaments (tissues that bind joints together) become stiffer and less able to bear stress.

When these tissues get weaker, the joints they support do too. Joint motion becomes more restricted and joint flexibility decreases.

Take control: Carrying too many pounds contributes to the breakdown of joint cartilage in hips and knees. Controlling your weight controls this risk. And regular exercise strengthens your muscles, giving your joints more support.

Did you know? Smoking makes it harder for your body to absorb calcium and easier for it to break down estrogen. Calcium and estrogen are important for good bone health in both men and women.

Heart

As we grow older, artery tissue stiffens and becomes less pliable, somewhat like a garden hose that gets brittle over time. Stiff arteries force your heart to pump harder.

And because the heart is muscle tissue, when it works harder it gets bigger. As the heart enlarges, its ventricles may not fill with blood properly. That makes pressure in the heart increase, forcing the organ to work harder still.

As the muscle overworks, it weakens. This leads to increased risk of heart failure, arrhythmias, heart attack and sudden cardiac arrest.

Over time, plaque accumulates in the arteries, too. This can block the flow of blood, raising the risk of heart attack.

Take control: Smoking and conditions such as high blood pressure and diabetes damage the inner layer of your blood vessels. The damage makes plaque more likely to stick to the vessels.

Eating well, getting regular exercise and stopping smoking help control these conditions.

Did you know? Too much sodium can raise blood pressure. But potassium-rich foods can blunt sodium's effects. Good sources include sweet potatoes, spinach, bananas and beans.

Scar tissue can cause a variety of issues

Scar tissue is a unique type of connective tissue. While it serves a purpose in the healing process, it can occasionally cause problems in the form of adhesions. These fibrous bands of tissue commonly develop in the abdomen after surgery — sometimes even years later.

Adhesions can also result from infection; endometriosis (when tissue that normally lines the uterus grows to areas such as the ovaries or the bowel); and pelvic inflammatory disease, a complication of sexually transmitted infections like chlamydia or gonorrhea.

Pain and discomfort

Adhesions cause tissues or organs to stick together. Most people have no symptoms, but some people feel pain or tightness. For instance, if you have an adhesion on the bladder, you might feel pain when it fills and expands.

"Adhesions can cause tension, and tension causes discomfort," says Bruce Rosenzweig, MD, a urogynecologist at Rush. In some cases, adhesions go beyond pain and cause an obstruction. "If there's a blockage, surgery becomes necessary," he says.

Fertility and pregnancy

Women may face fertility issues if adhesions kink fallopian tubes or twist them out of place. Often, surgery to remove adhesions can make pregnancy possible. But another surgery means additional adhesions may form down the road.

Because so much has to go right for sperm to meet up with an egg and create a baby, you have to take into account the risk of forming more adhesions.

Take control: If you're considering becoming pregnant and have these adhesions, talk to your doctor to weigh a variety of factors, including your age, when deciding whether to remove adhesions or turn to assistive reproductive technology, such as in vitro fertilization.

When disease makes tissues go bad 

Surgery isn't the only thing that can affect tissue. Disease can as well.

Inflammatory bowel disease (IBD) is the overarching term for a number of conditions that damage the tissues of the gastrointestinal tract, causing inflammation, swelling, sores and bleeding. The two most prominent are ulcerative colitis and Crohn's disease.

These conditions are typically first diagnosed among people in their midteens to late 20s and are often similar. But ulcerative colitis affects just the colon and rectum and tends to be located in one area.

Crohn's, on the other hand, can affect any part of the digestive tract from the mouth to the anus, and it can cause multiple areas of disease, with normal tissue in between, says Bruce Orkin, MD, a colon and rectal surgeon at Rush.

Exactly what causes these disorders isn't known, but it's believed to be an immune system malfunction. Typically, your immune system revs up when you’re dealing with an infection or other threat and then eases off when the threat is over.

"In people with IBD, it seems the down-regulation doesn't occur normally," Orkin says. The immune system may remain in a heightened state continuously or spiral up and down.

Take control: Treatment for these disorders is largely the same, often involving medication and dietary changes. However, sometimes surgery is necessary.