Linking mechanical injury to multiple non-communicable diseases: a hypothesis

Expelling materials forcefully from any of the body orifices during coughing or Valsalva manoeuvre (straining) on defaecation generates a sudden rise in pressure in the head, chest and abdomen simultaneously with compression of structures contained therein, resulting in a widespread crushing effect. Clinical observations that provide instances of major focal injuries due to this mechanical factor, evoke an argument that other, minor, concealed, recurrent injuries exist. The cumulative effects of these recurrent mechanical injuries and the body responses to them cannot be totally chaotic and are bound to result in focal and/or systemic effects resembling those due to common non-communicable diseases. On the other hand, major environmental risk factors of common non-communicable diseases are found to be responsible directly or indirectly for forceful expulsion of materials from body orifices. Thus, because of the observed non-random pattern of relationships which are unlikely to be due to chance it is tempting to speculate that mechanical injury may be an important common pathway linking diverse environmental risk factors with common non-communicable diseases.