Syndrome

A โ€œSyndromeโ€ is a collection of symptoms of conditions which we suspect means something, but canโ€™t really prove it.  Itโ€™s contrasted to a โ€œDisease,โ€ which has a definite way of being proved.  So for example, people with โ€œIrritable Bowel Syndromeโ€ (IBS) may have abdominal pain, constipation, and/or diarrhea, which can be bothersome or even disabling, but thereโ€™s no way to prove exactly what is happening in the body, because all tests are normal.  โ€œInflammatory Bowel Diseaseโ€ (IBD), however, causes ulcers in the bowel, can be identified by biopsy, and if severe, can require removal of part or even the entire bowel.  Occasionally people can die from IBD, never from IBS.

โ€œAcquired Immunodeficiency Syndromeโ€ (AIDS) is also a โ€œsyndrome,โ€ and people certainly can die from it.ย  The reason itโ€™s called โ€œsyndromeโ€ instead of โ€œdiseaseโ€ was that when first recognized in 1981, all we knew was that some people were suddenly developing a wide variety of fatal infections that had previously been extremely rare.ย  They were caused by โ€œopportunisticโ€ germs that are so weak that they never caused illness.ย  All of use have them in us, but almost nobody ever gets sick because our immune system controls them โ€“ unless, of course, the immune system weakens for some reason.ย 

So the term โ€œAIDSโ€ was applied to anyone with โ€œopportunistic infections,โ€ meaning for some reason, they had lost their immune systems.  But we didnโ€™t know why, so we couldnโ€™t say it was a โ€œdisease.โ€  Then, when a previously-unknown virus was found to be responsible, it was named โ€œHuman Immunodeficiency Virusโ€ (HIV), and we do speak of โ€œHIV Diseaseโ€ (though just say โ€œHIVโ€ for short).  Really, AIDS is nothing more than end-stage untreated HIV infection, but we still use the term.  By the way, the โ€œAโ€ which stands for โ€œAcquiredโ€ is because thereโ€™ve always been rare immunodeficiency diseases babies are born with; theyโ€™re โ€œcongenitalโ€ instead of โ€œacquired.โ€

So back to the term โ€œsyndrome,โ€ โ€“ syndromes are certainly illnesses, but ones which canโ€™t be precisely defined by biopsies, x-rays, blood tests, or anything.  IBS is thought due to disturbances in the rhythm of the bowel, but nobody can prove it.  Maybe someday they will.

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