From afar, specialists ponder Arafat's declining health

The cause of Yasser Arafat's illness has not been disclosed by French doctors, but several Boston-area gastrointestinal specialists said his reported symptoms -- intestinal and stomach inflammation, blood-clotting problems, eating difficulties -- are consistent with a range of intestinal and liver afflictions that are not uncommon in a 75-year-old man.

The specialists discounted an explanation offered by Palestinian officials who, after visiting the comatose Arafat on Tuesday, sought to blame his deteriorating health on his being confined by Israel for three years in his squalid Ramallah headquarters.

Regardless, the mystery of what made Arafat gravely ill may never be solved: Islamic tradition calls for him to be buried with 24 hours of death, leaving no time for an autopsy.

"I don't think we'll ever know" what is ailing Arafat, said Dr. Andrew G. Plaut, director of digestive disease research at Tufts-New England Medical Center.

Arafat was in a deep coma yesterday, connected to a respirator and feeding tube, French and Palestinian officials said yesterday.

They said he had suffered brain damage from a hemorrhage, kidney failure, and liver failure.

What little the world knows of Arafat's health comes from Palestinian foreign minister Nabil Shaath.

After days wild rumor -- he's dead, he's not dead -- Shaath gave a vague description of Arafat's ailment earlier this week in Paris, where the Palestinian leader has been hospitalized.

"We don't have a full understanding of why his status has deteriorated, which means that we don't really have a full diagnosis," he said.

Shaath said French doctors ruled out cancer and poisoning. He acknowledged there was no definitive diagnosis, then said Arafat's "difficult life" was likely to blame.

Arafat, 75, has spent the last three years largely confined to his headquarters in Ramallah, where, Shaath said, he had "very little oxygen and very bad sanitary situation, ensieged by the Israeli army, [which has] contributed to a varieties of digestive tract ailments."

The ailments led to stomach and intestinal inflammation, making it impossible to eat, Shaath said, adding that malnutrition led to the organ failure that has left him in a coma.

But Plaut and other Boston-area specialists interviewed were skeptical of that explanation.

"When you look at the American elderly at age 75, many of them are confined. Confinement alone, I think, didn't do this. That's a big stretch," Plaut said.

Several physicians, most of whom asked for anonymity to keep out of the political debate over Arafat, speculated that Arafat might have had cancer that spread to his liver, though Shaath said French doctors ruled cancer out.

Dr. Michael Wolfe, chief of gastroenterology at Boston Medical Center, said metastatic liver disease from a cancer elsewhere in his body was "my first guess" judging from the rapid weight loss, apparent in media images, that Arafat has suffered in recent months.

Plaut said, "I could diagnose 25 possible disorders," including cancer and intestinal damage linked to bad arteries, based on the limited information released thus far.

Raja Mishra can be reached at rmishra@globe.com.