Breast discharge is a worry for women

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DEAR DR. DONOHUE: I need your help. I am a 43-year-old woman, and I have a breast problem. Last night on the side of my nipple, there was thick, yellow mucus coming out, and on the front there was thick, brown mucus. What could this be? — Anon

 ANSWER: Nipple discharge brings fears of cancer, but in only five out of 100 instances is it a sign of cancer or any other serious condition. Manipulation of the breast accounts for most discharges. Running without a good support bra or frequent examinations looking for a lump are examples of manipulations that cause nipple discharge. The color of such discharges varies from green to dark brown.

 Spontaneous leakage from the nipple — a discharge not due to any mechanical stimulation of the breast — is frequently caused by a benign condition called an intraductal papilloma, a noncancerous growth in a milk duct. Such discharges are watery, sticky or even bloody. Milky breast discharges point to an overproduction of prolactin, a hormone coming from the pituitary gland at the base of the brain. Breast infections give rise to a yellow discharge. Breast cysts can cause a brown or green leakage. Birth-control pills are another reason breasts leak.

 I cannot pinpoint the cause of your leakage. You have to see a doctor. The doctor can perform tests that will rule out the specter of cancer, no matter how slight that might be. The doctor will determine if you need a mammogram for a definite diagnosis. If you had been doing so, don’t manipulate your breast or try to express fluid until you see the doctor. It might put an end to your problem.

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 DEAR DR. DONOHUE: My daughter was just told she has IBS (irritable bowel syndrome). She is home from the hospital now, but the doctor gave her no dietary restrictions.

 Should she be avoiding certain foods and concentrating on others in her daily diet? — E.R.

 ANSWER: Irritable bowel syndrome is a very common condition. It’s frequent and recurrent abdominal pain with a change in stool frequency, appearance or consistency. Affected people are either constipated, have diarrhea or alternate between the two. The abdominal pain is crampy and often relieved by a bowel movement. Bloating and gaseousness are two other frequent complaints.

 The cause of IBS is an unsettled issue. It might be that the muscles of the digestive tract are out of harmony with each other or that the tract is unusually sensitive to signals not perceived by others as painful.

 It’s logical to assume that diet would be a major factor in controlling symptoms. It is to an extent, but patients have to determine for themselves which foods are well-tolerated and which ones cause them grief. There are no general diet recommendations. An increase in fiber often is suggested. It works well for both constipation and diarrhea. Psyllium is the fiber product frequently advised. Brand names are Metamucil, Fiberall, Natural Psyllium and Perdiem. Oats are another fiber source for IBS. Peppermint oil benefits some. It can cause heartburn, but when it comes in enteric-coated capsules, it is well-tolerated by all. Probiotics — preparations that populate the digestive tract with friendly microorganisms — can soothe IBS. Culturelle and Florastor are two such products.

 DEAR DR. DONOHUE: What is Asperger’s disorder? How does it affect people? What is the appropriate treatment for it? — R.S.

 ANSWER: Children and adults with Asperger’s disorder usually have normal or high intelligence. Social skills are lacking. They find it difficult to interact with others, to appropriately express emotions and to understand the significance of facial expressions and both verbal and nonverbal communication of feelings. They devote themselves to a few interests and want to discuss those interests at length with others who lack any attraction to the topic. Establishing friendships is difficult. They tend to lack motor skills and are poor at athletics or anything that requires a modicum of coordination. Finding a team of skilled professionals with training in interacting with Asperger’s patients is the key to treatment. The family doctor can assist people in locating these professionals.

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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