Zinc: Second on my list of imprortant minerals.

Zinc is a mineral involved in over 100 enzymatic reactions in the body! It is necessary in adequate levels for cellular metabolism.

It is critical for the function of our immune system, our skin and our gut lining.

At the cellular level zinc is necessary for protein synthesis, DNA synthesis and cellular repair in wound healing.

Zinc is primarily found in the brain, muscles, bones, kidney, liver and prostate. It is yolked to copper in serum concentrations. Low zinc is associated with elevated copper and this is associated with neurological abnormalities.

Deficiency of zinc occurs with a disease known as Acrodermatitis Enteropathica and also inadequate dietary zinc intake. Deficiency can lead to severe diarrhea, severe immune dysfunction, rashes, depression and growth failure.

Some common symptoms and diseases related to insufficient zinc include: recurrent infections, chronic mild diarrhea and diaper rashes, macular degeneration, worsening atopic diseases like eczema and asthma.

Food sources of zinc: Oysters are the bounty with 74mg per serving. Meats, fish, beans, nuts and dairy contain 7 mg or less per serving.

Zinc supplements can interact certain antibiotics and diuretics. Ask your pharmacist if you are taking zinc and prescribed one of these medicines.

Take home point: if you have chronic diarrhea or get sick frequently, you may be low in zinc. Load up the meats, fish, beans, nuts and dairy.

———–

Appendicitis management is in the news. Historically, appendicitis was diagnosed by right lower quadrant abdominal pain, nausea, fever and maybe vomiting.

The subsequent treatment was always surgical appendectomy. Over the past decade, a few rogue surgeons did the unthinkable and treated only with antibiotics and prevented countless surgeries and the inherent cost and morbidity.

Dr. Deans and colleagues researched this topic in the journal JAMA Surgery this month. They go on to say that if a patient has uncomplicated surgeon confirmed appendicitis

Uncomplicated appendicitis is defined as an inflamed but grossly intact, nongangrenous, nonsuppurative appendix with no associated abscess or peritonitis; then a family can choose 24 hours of IV antibiotics followed by 10 days of oral antibiotics or surgery.

In their study, the antibiotic group had a 76% chance of resolution and non recurrence. There was only a 2.7% complication rate. The non surgical group also had 13 less days of pain and decreased function and an 800$ cheaper price tag.

Why not just take it out? Some advocate for this. However, the appendix serves a major function in housing our good gut bacteria and recolonizing the intestines following a bout of severe diarrhea or other gut infection. People who have their appendix removed have a 3 fold increased risk of secondary problems like C. difficile colitis. The C diff infection is getting harder and harder to treat effectively (fecal transplants are showing promise though).

As always, there is no free lunch. Each pathway has risks and benefits. Adding in some probiotics makes the conservative antibiotic route more interesting to me than the surgical/anesthesia option.

Know the data and make an informed decision if you are faced with appendicitis.

Dr. Chris Magryta is a physician at Salisbury Pediatric Associates. Contact him at  newsletter@salisburypediatrics.com