It’s not always necessary to treat ulcer germ

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DEAR DR. DONOHUE: I am a pretty healthy and active 83-year-old man who has had H. pylori for several years. My internist feels that, since it has not caused me problems up until now, he would be reluctant to treat it with medicine. Do you feel I am exposing myself unnecessarily to future ulcers or stomach cancer? Is the breath test more reliable than the blood test? If I am H. pylori-free, can I get reinfected by kissing? – M.B.

ANSWER: Helicobacter (HEEL-ik-oh-BACK-tur) pylori (pie-LORE-ee) is a germ associated with stomach and duodenal ulcers and some stomach cancers. There is much more to the story than that, and the additional information can be confusing.

The finding of H. pylori in a person’s stomach does not always indicate illness or future illness. It is found in 50 percent of people older than 60 and in 20 percent of those in their 30s. That makes it a common infection. In most people, the germ sits in the stomach without creating a fuss.

On the other hand, if a person has both ulcers and H. pylori, then the attempt is made to get rid of the germ. (Stomach cancer has a different story.) A program of antibiotics and acid-control medicines heals the ulcer and evicts the germ – usually. Getting rid of the germ is insurance of not having the ulcer return.

You have neither an ulcer nor stomach cancer. Leave your H. pylori alone. It’s wise to let sleeping dogs lie.

One of the best tests for detecting the germ is the urea breath tests. For this test, special urea with radioactive carbon is given to patients to drink. The H. pylori germ digests urea and releases radioactive carbon dioxide, which can be detected in the breath. The word “radioactivity” floors people; don’t let it. The radioactivity in this test is so low that it is no threat to health.

You don’t get H. pylori from kissing. How it’s passed from person to person isn’t clear. Your doctor has counseled you wisely.

DEAR DR. DONOHUE: I am writing about a rumor (I hope it is a rumor) that if you take flu shots five years in a row, you will get Alzheimer’s disease. I have taken shots every year since 1980. I do have some forgetfulness. Will you comment on this? – M.S.

ANSWER: Where did this rumor come from? It’s poppycock. You can take the flu shot for 100 years in a row and not come down with Alzheimer’s disease.

Your handwriting is beautiful. Your thoughts are clearly expressed. There’s not even a hint that you have Alzheimer’s.

If your memory lapses are the sort that you forget where you put your keys, join the crowd. If they are the sort that you don’t know what familiar keys are for, then you might have a sign of Alzheimer’s.

The Alzheimer’s booklet provides details on this tragic illness. Readers can obtain a copy by writing: Dr. Donohue – No. 903, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6.75 Can. with the recipient’s printed name and address. Please allow four weeks for delivery.

DEAR DR. DONOHUE: I took Lipitor in December 2004 and January 2005. Shortly after, I looked in the mirror and saw a huge lump on my upper arm. The first doctor who operated on it said it was bone cancer. A second doctor refused to operate on it. The third doctor (I went to a large medical center) said it was a rare muscle cancer and took it out. Now I am on chemo.

Lipitor causes muscle weakness. Could it cause muscle cancer? – S.J.

ANSWER: Lipitor and its many relatives can sometimes give rise to muscle pain and muscle weakness, but not too often. In very rare instances, they can cause death of muscle cells.

A recent report in the January 2006 issue of the Journal of the American Medical Association states that no statin drug – and Lipitor is a statin drug – increases the risk of any cancer.

I am sorry all this was heaped on you, but I sincerely believe Lipitor had nothing to do with it.

DEAR DR. DONOHUE: I am 75 and about 30 pounds overweight. My last blood sugar reading was high. My doctor put me on a 1,800-calorie diet and told me to watch my intake of carbohydrates. I count my calories, but I have no idea of how many carbohydrates I can eat a day. Can you help me on this? – C.G.

ANSWER: Standard diabetic diets call for a carbohydrate amount that is 50 percent to 55 percent of the total daily calories. For you, that would be 900 to 990 carbohydrate calories a day. A gram of carbohydrates has four calories. Therefore, you can eat 225 to 247 grams of carbohydrates a day – 7.8 to 8.6 ounces.

Most of the carbohydrates you eat should be ones that release their sugar content into the blood slowly. The rapidity of sugar release into the blood is the glycemic index. Foods with high glycemic indexes include white bread, white rice, potatoes, pretzels, honey and raisins. Eat such foods sparingly.

You can eat small amounts of table sugar. A teaspoon of it has 16 calories.

It’s impossible for the average person to understand a diabetic diet without instructions from a dietitian. Your local hospital might sponsor a program of instruction, or the local chapter of the American Diabetes Association can tell you where to locate such people.

If you manage to lose that extra 30 pounds, you might find that your blood sugar has returned to normal. Fat interferes with the action of insulin.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from www.rbmamall.com

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