What happens to Leo Messi

Call it a case that helps us analyze diseases of the upper gastrointestinal tract.

Few months I've been thinking about this happening to Leo Messi. If anyone has to call

his attention to see a world football star vomiting, imagine what can a gastroenterologist doctor like me thinks to see how time and again, in the fields during workouts and even in matches, this young man athlete, apparently healthy, has to bend himself and induced vomiting of considerably bilious contents, in view of the television cameras. I have to say I do not know Leo Messi in person, and don't know his medical history. What's more, not even knew his condition up viewing him vomit live in a party that, as I remember, it was a Barcelona-Real Sociedad. That day, as I saw the play, chatted with a friend doctor, who is also a footballer, and we agreed that the liquid expelled in abundance was no saliva, it is known that the players expelled little dryness that causes them that in the airways. For its abundance seemed bilious, vomiting dark liquids without food content seems that Leo himself provoked to get relief after noticing the accumulation of fluid in the upper digestive tract. Doctors, like detectives uses deduction techniques from each other based on clues and symptoms (discomfort or changes to the patient) or signs (findings on examination, visualization, palpation or auscultation). This deductive thread usually qualify it with the experience of each professional, and thus pose a clinical trial, which is a starting point and then confirm data and arrive at a diagnosis. This is what I intend here, raise a basis on which to develop after the diagnosis, which is what more I can choose without studying the patient. Then reality will put you in your place, based on the dumbest or assume the most obvious truism detail and not just have to be true. For example, I was among those who thought that Fidel Castro had died many years, because I could not assume that such an important person medical team and staff who allegedly controlled, you will escape a colon cancer. Did not understand that Mr. Castro dies of colon cancer just a cancer early detectable and preventable. I was inclined to Castro were embalmed like Lenin, waiting for a good time in which advanced the Cuban transition was appropriate to announce his death without fear of unrest. I thought it might be other more aggressive cancer that had killed him, and that one of his doubles was so many that appeared in the press to give a sense of stability. However, the time "seems" to take away reason. Advance the months and years, and neither the Cuban transition progresses as some they supposed, and my experience of seeing characters and important leaders, that is unfortunately not so well controlled on his health as you might assume. Returning to the case of Messi, these symptoms are not characteristic of that, moreover, he for sure has an omeprazole or controlled GERD derivative; discard a toxic problem i don't think this guy would not have been detected by "doping"; I also suggest gastric origin, since vomiting without food content are repetitive and after them, the player is quickly recovered, and even score goals. That if, time base it shows in physical performance, every day moves less, or so it seems to me. In this case I focus on the duodenum and if he had to consult the Bokus, "bible of Gastroenterology," at least for me, I would put the chapter duodenal ileum. Ileo refers to a difficulty in transit somewhere in the intestine (ileum not mistaken, that so the final section of the small intestine, nor ilio, which is how a part of the hip bone is called). We would be talking about a difficulty that content from the stomach, bile and pancreatic fluids, passing through the duodenum. There are different causes of duodenal ileum, such as tumors, inflammatory strictures duodenal Crohn type, sequel of pancreatitis, retroperitoneal fibrosis by repeated blows of a professional boxers, workers using pneumatic hammers, etc ... I had the occasion to treat a patient trapeze with this problem, precisely because multiple strokes fallen on the abdomen on the post of the trapezoid. But overall, I discard these mechanical causes that would have detected in upper endoscopy to which he must have gone though to be submitted in Barcelona. Nor do I think congenital causes of mechanical ileum, as abnormal fibrous bands, type the accurate ligament syndrome, annular pancreas, membranes or non well positioned at birth and vascular structures that could compress the duodenum. Such anomalies would have given his face well before and if not, and would have detected my friend Rafael Ramos in any imaging technique. Just happen to the duodenal, RARE achalasia, which would have been detected on barium study. If I had to define myself, I would think in "The Complete plaster Syndrome". This clinical picture described by a colleague called Dorph in patients who had been casts around the trunk. It seems that the cause lies in an exaggerated swayback and fixed in young patients who still have very flexible column. Let me explain: The duodenum is the intestinal segment that follows the stomach, has a "c" and its distal horizontal segment passes in front of the right column in its most anterior point, and people with arched spine forward compression the duodenum would increase. On the other hand, athletes who have a rectus muscles strong and rigid abdomen, these acts similarly to the "cast" and provoke a major duodenal compression causing it to collapse, preventing stomach emptying and force vomit. Once the abdominal muscles relaxed and paraspinal muscles stop tighten the column after the game, the problem would yield, and radiologic studies would identify the problem easily. Anyway, that's what I think, and how little, this has allowed us to review the causes of duodenal ileum. And if we help to improve Leo Messi, the better.