Health information

QUESTION: I enjoy reading your column and wonder if you will now answer a
question for me
Last week I had a bran cereal breakfast, and then for lunch
ate a meal including broccoli, stuffing, mashed potatoes and gravy
When
returning to my apartment, I just about had to run to get to the bathroom.
Was it the bran, or the coffee or what? Something really worked on my bowels.

ANSWER: A bran cereal can be a rich source of dietary fiber, but so are
broccoli and potatoes
It sounds like you have experienced the results of a
“fiber overdose,” which can occur when you consume a great deal of fiber all
at once, more than your digestive tract is used to handling
There is no
question that dietary fiber can be an excellent part of a healthy diet,
providing the roughage your system needs to function properly
It is found in
plant foods such as whole grains, fruits and vegetables, and in the past was
known to be helpful in “cleaning you out”
After food is digested in the
upper gastrointestinal tract, much of the fiber arrives in the colon
relatively unchanged
There the fiber can absorb water, which increases the
weight of the stool as well as expanding its bulk
This increase in volume
creates a pressure within the colon and boosts the muscular action of the
colon wall that propels the material out of the system
High fiber stools are
usually softer and more pliable than those with little fiber, and are easily
propelled by the colon
The rest, as in your case, is history
However, you
can overcome this difficulty by adding fiber rich foods to your diet in small
amounts
Gradually your digestive system becomes adapted to the content and
size of your stool, and can handle it quite easily
The benefits of fiber
rich diet are many, including reduction in blood cholesterol and possible
preventing colon cancer, so this diet deserves another chance
Until you do
adapt, however, you had best take your meals a bit closer to home.

The material contained here is “FOR INFORMATION ONLY” and should not replace
the counsel and advice of your personal physician
Promptly consulting your
doctor is the best path to a quick and successful resolution of any medical
problem.

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QUESTION: My wife is on a health food kick, and is now serving a lot more
fish than we are used to eating
I don’t mind getting used to this new diet
if I was sure that it was doing me some good
Do you feel that all the health
claims about fish are sufficiently true to make this change?

ANSWER: I doubt that your wife is alone in changing the cuisine that is being
served at the table in most American homes, for the idea that new dietary
habits can reduce the numbers of many of the leading causes of death is now
pretty well accepted by various authorities
The belief is that high levels
of cholesterol and saturated fat lead to heart disease, high blood pressure,
and stroke, and that lowering the quantities of foods that contain large
quantities of these substances can help to protect us
The recommendations of
both the American Heart Association and the National Cholesterol Education
program is to consume a diet containing less than 30 percent fat calories per
day, and no more than 300 mg of cholesterol
The fats or oils in fish differ
from those found in animal products and include a highly polyunsaturated
omega-3 fatty acid, which is thought to be the element in the diet of the
Eskimos of Greenland which seems to protect them from heart disease and
stroke
Cold water fish are particularly high in this fatty acid, so choose
from halibut, salmon, snapper and rainbow trout for your source
Natural
sources are preferable to capsules which do not contain the wide variety of
vitamins and minerals found in seafood which are so important to a healthy
diet
The preparation of seafood is also important if you are to profit from
your new food choice
Fish are best served boiled, broiled, baked, poached,
steamed or grilled, but frying in high saturated fats is certainly a no-no.
Choose vegetable oils for food preparation when necessary, using oils such as
safflower, sunflower, olive, or corn
Eating a fish dish or two during the
week as a substitute for meat will help cut back on the saturated animal fats
they contain, but still leave room for a lean, well trimmed steak or slice of
beef to be included in your week’s menu.

The material contained here is “FOR INFORMATION ONLY” and should not replace
the counsel and advice of your personal physician
Promptly consulting your
doctor is the best path to a quick and successful resolution of any medical
problem.

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QUESTION: My mother, who has been suffering with urinary difficulties,
reports that her doctor told her that she has “female prostatic obstruction”.
Come on now, everyone knows that the prostate is found only in men! What is
this, another medical put on?

ANSWER: No, it is not a put on, though the explanation surely must have been
accompanied by additional information
In certain cases of obstruction of the
neck of the bladder, which can cause symptoms ranging from painful urination
(dysuria) to complete bladder obstruction, the cause is thought to be the
inflammation or growth of glandular tissue found in the area
It is known as
“Marions’ Disease” or the “Bladder Neck Syndrome”
Because x-rays of the
region show a pattern similar to that seen in men with prostatic enlargement,
it has also been called “female prostatic obstruction,” although many authors
dispute both the name and this explanation for the condition
However,
surgical removal of the tissue yields good results.

The material contained here is “FOR INFORMATION ONLY” and should not replace
the counsel and advice of your personal physician
Promptly consulting your
doctor is the best path to a quick and successful resolution of any medical
problem.

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QUESTION: A dear member of our family has been discovered to have a stomach
cancer
We were all a bit shocked at first, and realized that we haven’t read
too much about this disease lately
Is there some reason for this? Can you
tell us where the disease might have come from? Could it have resulted from
an undiagnosed ulcer? Thank you for your help.

ANSWER: Stomach cancer, or as the physicians put it, gastric carcinoma, still
is an important disease, the eighth leading cause of deaths due to cancer
In
1988 an estimated 24,800 Americans were diagnosed to have the disease and
resulted in about 14,400 deaths
There is great interest in the cause of this
type of cancer, for the number of cases seen in the United States has
decreased to about half the number of cases that were seen back in 1930
The
death rate has diminished from about 38/100,000 population to about 8/100,000
at present
And researchers are not sure why this has occurred, for the
origins of stomach cancer are not clear and specific cancer causing substances
have not been identified
Some investigators believe that gastric carcinoma
may be related to factors in the environment
When people move from areas of
the world where there is a great deal of stomach cancer to places where it is
much lower, they too seem to lose their risk of developing the disease
One
of the factors that is suspected of being linked to this cancer is a diet that
is high in salted or smoked foods
Certain occupations such as nickel
refining in Russia, coal mining and farming in Japan, and lumber and rubber
processing seem to be associated with a higher risk
In addition, it is more
common in the lower socioeconomic groups
It occurs more frequently in people
with pernicious anemia, but does not seem to be related to gastric ulcers
It
once seemed that people with “A” blood type were more susceptible to
developing the disease, but this is no longer thought to be true
Early
diagnosis is not easy, as there are no specific symptoms associated with the
disease, although the complaint of mild stomach discomfort that may be
relieved by antacids is frequent
A complete examination with appropriate
x-ray studies and endoscopy and biopsy can lead to an accurate diagnosis.

The material contained here is “FOR INFORMATION ONLY” and should not replace
the counsel and advice of your personal physician
Promptly consulting your
doctor is the best path to a quick and successful resolution of any medical
problem.

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QUESTION: Recently a friend told me of a new procedure for removing
gallstones that didn’t involve major surgery
She didn’t have the details
down too good
Something about a one inch incision near the belly button and
a tube inserted to suck out the gall bladder or stones and that the patient
only had to stay overnight at the hospital
Can you give me some real
information about this? I’d appreciate it very much.

ANSWER: Certainly
Here’s the real inside story, but hold on to your hat,
the name of this new surgical procedure is a doozy
It called “laser assisted
laparoscopic cholecystectomy” and as you indicated removes the diseased gall
bladder through a small incision made in the patient’s navel (or “belly
button”) instead of the large incision in the abdomen that is used for
standard gall bladder surgery
It must be performed under general anesthesia
and takes about one hour to perform
Actually there are four small, one inch
incisions needed to perform the procedure
Besides the one at the naval,
another is made beneath the breastbone, and two more below the ribs
Through
these incisions, the surgeon will place the laser, used to cut the gall
bladder away from the liver, and the “laparoscope”, an instrument which
permits the physician to see what is going on
The other incisions or cuts
are needed to insert instruments which can grab on to and move the gall
bladder about
Although standard gall bladder surgery is safe and effective,
the larger incision (about 4 to 6 inches) causes greater pain and requires
both a longer hospital stay and a longer time to heal after surgery
With
this new procedure, the patient is out of the hospital and back to work in
about a week’s time
However, there are still situations in which the
standard operation is preferable, when previous operations may have left
adhesions and scars that make additional surgery more difficult to perform, or
when a gallstone is blocking the tubes leading from the gall bladder to the
small intestine
If you have a personal need, you may want to check with your
local hospital to see if they are equipped to perform this newly developed
operation.

The material contained here is “FOR INFORMATION ONLY” and should not replace
the counsel and advice of your personal physician
Promptly consulting your
doctor is the best path to a quick and successful resolution of any medical
problem.

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QUESTION: I would like some information on esophageal reflux
I’ve been
diagnosed as having this and have had the problem for two years
I do not eat
any acid or spicy food and do not drink coffee
I have a burning sensation in
the chest and of the mouth and lips and wonder if this is due to the disease.
I would appreciate any information about treatment that you may be able to
give me.

ANSWER: Gastroesophageal reflux disease (GERD) refers to an entire group of
digestive disorders with the symptoms you describe
This acid backflow
(reflux) creates a burning sensation or heartburn behind the breastbone that
occurs after eating or while lying down
This burning is caused by the acid
contents of the stomach flowing backward into the lower end of the esophagus
(the tube leading from our mouth to the stomach), where it irritates the
tissues and creates the pain
It is difficult to state with certainty that
your lip and mouth pain are from the same cause, but it is possible.
Initial treatment of GERD is conservative
Since the condition involves
gastric backflow, lifestyle changes may be the cornerstone of good therapy.
Modifying the diet, as you are doing, to exclude foods that irritate the
mucosal tissue, like tomato or orange juice, may help
Coffee is frequently
named as a culprit, as are alcohol and chocolate
Decreasing or stopping
smoking altogether is also helpful
Eating meals well before bedtime and
elevating the head of the bed to prevent backflow are additional good tips.
H2 antagonists such as cimetidine and ranitidine, which reduce gastric
acidity, are frequently used to treat these disorders
When heartburn does
strike the use of antacids is appropriate.
If these measures do not provide lasting relief, and when there is
serious inflammation of the esophagus leading to hemorrhage and strictures
from scarring, surgery to “tighten” the sphincter muscles of the esophagus may
be indicated.

The material contained here is “FOR INFORMATION ONLY” and should not replace
the counsel and advice of your personal physician
Promptly consulting your
doctor is the best path to a quick and successful resolution of any medical
problem.

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QUESTION: I don’t know how to take the reporting about President Bush’s
glaucoma
Are they playing it down, so that people won’t get worried about
the ability of the President to function? Doesn’t this disease lead to
blindness? Perhaps you might want to explain this condition to your readers,
so they will know what is happening in the White House.

ANSWER: I am not sure that I am the one to comment on events in the White
House, they are confusing to me as well
But one thing is for sure.
President Bush is putting in his eye drops just as the doctor ordered.
Therefore it is highly unlikely that he will lose any of his vision, or be
unable to carry out his responsibilities
Glaucoma is a disorder
characterized by an increase of pressure within the eyeball
The eye produces
a fluid (aqueous humor) which circulates through the globe of the eye before
leaving through exit canals near the base of the iris
If either too much
fluid is produced or there is a blockage of the outflow passages, the tension
or pressure within the eyeball increases
This pressure pushes against the
optic nerve, damaging it and causing a very gradual loss of vision
Blindness
may occur, but only in those individuals where the diagnosis is late and
treatment has not been carefully carried out
The progress of the condition
is evaluated using an instrument called a tonometer, which can accurately
measure the intraocular tension (pressure within the eye)
Since the iris may
push against the canals which carry the fluid away from the eye when they are
dilated or widely opened, the drops carry a medication which keep the iris
closed (called “miotics”)
Many such medications are available; pilocarpine,
timolol and betataxolol to name a few
For the greater majority of patients
with this condition, the drops will be enough to control the disease and
prevent serious damage of the vision
The President will have to restrict his
liquid intake, avoid tobacco (I don’t think he smokes) and, according to the
textbooks, avoid fatigue and stress (don’t ask me how he will manage that!).
Should his therapy with eye drop medicine fail, there are surgical techniques
called iridectomy or laser iridotomy that can be used to relieve the pressure
by removing a bit of the iris that pushes against the outflow canals.

The material contained here is “FOR INFORMATION ONLY” and should not replace
the counsel and advice of your personal physician
Promptly consulting your
doctor is the best path to a quick and successful resolution of any medical
problem.

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QUESTION: Sometime ago you gave us an address where one could get all sorts
of government publications
Though I clipped your article with every good
intention of writing, I misplaced it
I would very much like to get this
information and am requesting you to publish the address once again.

ANSWER: Happy to oblige, as I have had many similar requests
The trick, of
course, is to get your letter off promptly, or to transfer all addresses of
offers and other interesting items to a note book, which is less likely to be
misplaced
The address you wish is the Consumer Information Service, P.O
Box
100, Pueblo Colorado, 81002
Their catalogue contains information on
publications of all types, not just health and medicine, and the prices range
from “free” to several dollars for books that are usually well worth the
price.

The material contained here is “FOR INFORMATION ONLY” and should not replace
the counsel and advice of your personal physician
Promptly consulting your
doctor is the best path to a quick and successful resolution of any medical
problem.

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QUESTION: My husband’s hair is just beginning to turn gray
I think it gives
him a rather distinctive look
He says it is from all the worry he has had,
but I remind him that his Dad also turned gray at an early age
Can you
explain what causes hair color to change this way, and if it really can have
anything to do with stress and worry?

ANSWER: The color in hair is the result of the presence of a pigment called
“melanin”
The wide range in colors from blonde to black reflects the
different amounts of the pigment contained in the shaft of the hair
Redheads
can also vary in the intensity of hair color, but their hair contains a
different pigment called “pheo-melanin”
Hair color turns gray (or white)
gradually as the amount of pigment produced by the hair follicle reduces with
age
Although this follows the general rule that many body functions slow
down a bit as we age, the pattern of hair color follows the influence of the
genes we have inherited from our folks
Your father in law’s early graying
may certainly be the indication of his gene actions and the source of the
early changes your husband is experiencing
However these patterns can vary
from individual to individual, and while some begin to show signs of gray as
early as the teens and twenties, others may retain a full colored head of hair
into their 60’s and 70’s
A temporary graying of the hair can be due to
severe disease or malnutrition, which when corrected allows normally colored
hair to grow once again
But this does include the normal stresses of daily
living
Thus the tales of someone turning gray “overnight” following a shock
or severe fright are just another one of the many myths that revolve about
hair growth and color
It sounds as if your husband is experiencing a normal
transition without cause for undue anxiety.

The material contained here is “FOR INFORMATION ONLY” and should not replace
the counsel and advice of your personal physician
Promptly consulting your
doctor is the best path to a quick and successful resolution of any medical
problem.

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QUESTION: I don’t believe you have ever addressed the problem of endometrial
cancer in your column
Could you please explain the causes of this disease
and how it is diagnosed?

ANSWER: Endometrial (inner mucous membranes of the uterus) cancer is the most
common cancer occurring in female reproductive tracts, and ranks third in
cancers affecting women, after breast and colorectal cancers.
Women most likely to develop endometrial cancer are those who: have not
had children, are obese, have diabetes and/or high blood pressure, and reach
menopause past the age of 52 years (delayed menopause)
A family history of
breast or ovarian cancers may be another risk factor
Women with all the
above have very high risks of such cancers.
About 28,000 news cases are diagnosed each year
Endometrial cancer is
usually seen in post-menopausal women and the peak incidence of this disease
is between 50 and 60 years of age
It is possible that as many as 1/3 of all
cases of post-menopausal bleeding may be due to endometrial carcinoma.
Women who have taken progesterone therapy (including oral contraceptives)
for long periods and those who menstruate somewhat infrequently seem to have
fewer endometrial cancers than others in their age group.
Because endometrial (as well as cervical) cancers are the most common
cancers associated with abnormal bleeding, endometrial biopsy and Pap smears
are extremely important in establishing the correct diagnosis.
A large number of postmenopausal women who bleed abnormally develop
malignancies of the reproductive tract (involving fallopian tubes, uterus,
cervix, vaginas and/or vulvas)
Therefore, physicians are alert to these
possibilities and will use both Pap smears and biopsies of all suspected areas
(as well as other diagnostic tools) to seek out these cancers.
Women suffering endometrial cancer often develop breast and colon
cancers
That provides us with another important reason to recommend regular
checkups, to detect these conditions early on when treatment may be most
effective.

The material contained here is “FOR INFORMATION ONLY” and should not replace
the counsel and advice of your personal physician
Promptly consulting your
doctor is the best path to a quick and successful resolution of any medical
problem.

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