DEAR DR. DONOHUE: Please help us learn more about a disease called Peutz-Jeghers syndrome. Two years ago, when she was 16, my granddaughter had periodic, terrible stomach pain. My daughter took her to the emergency room for one of these episodes. Two hours later, she was in surgery for a bowel intussusception. Last week, she had pain on the right side of her abdomen. The doctors thought she had cysts on her ovary. No cysts were found, but her right fallopian tube was twisted. What’s going on? Will she continue to have these things happen to her? — C.A.
ANSWER: Peutz-Jeghers syndrome is a seldom-seen illness that’s genetically transmitted from either the mother or the father. However, in 25 percent of cases, no family member has the gene. In those circumstances, which sound like your granddaughter’s, a mutation occurred in one of her genes. This change generates the growth of hamartomas, polyplike structures that sprout from the surface of the digestive tract, mainly the small intestine. A hamartoma is composed of normal digestive tract cells that have been laid down in a disorganized way. In addition, dark-blue to brown spots are seen around the lips, nose, inside the cheeks and sometimes on the palms and genitals. They look like freckles.
Hamartomas lead to one part of the intestine being drawn into an adjacent section, much like a telescope can be folded into itself. That’s an intussusception (IN-tuh-suh-SEP-shun), which leads to bowel obstruction and abdominal pain. A twisted fallopian tube is not a common part of the syndrome.
This young girl is faced with recurring episodes of abdominal pain. She must be watched closely. She also must be followed for increased risk of cancers of the digestive tract (stomach, small intestine, colon and pancreas) and of the breast, uterus, lung and ovary. Her doctors must have alerted her parents to these possibilities. They are not certainties; they are only probabilities. Any doctor she consults must be made aware of her syndrome.
DEAR DR. DONOHUE: I have been diagnosed with gallstones through ultrasound. My choices are surgery now, or wait and see, since I have no pain. I’d like your opinion on this. Can gallstones cause problems elsewhere? I am 70. — M.B.
ANSWER: Close to 25 million Americans have gallstones. Up to 80 percent of these people do not know they have them. They never suffer any pain because of them. These are called silent gallstones.
The stones vary in size from a grain of sand to a golf ball. When a stone blocks the flow of bile out of the gallbladder, pain arises. Most often this happens after a meal, when the gallbladder contracts to empty bile into the intestine for digestion. The pain is severe and begins in the upper right side of the abdomen. It may penetrate to the area beneath the right shoulder or the area between the shoulder blades. It lasts from 30 minutes to hours.
You have silent stones. Only 10 percent of silent stones cause any pain or trouble in five years. After 15 years, around 18 percent of silent stones have kicked up a fuss. If a person with silent stones is pain free for 15 years, that person is most unlikely ever to experience an attack of gallbladder pain. The odds are in your favor that your stones will not cause you any trouble. Personally, I would choose not to have surgery. Most people in your situation do. Gallstones cause only digestive tract problems. They don’t cause trouble elsewhere.
DEAR DR. DONOHUE: I felt I had to tell you a simple remedy for body odor after reading your column. It’s milk of magnesia. I read about it in a newspaper and found that it really works. I no longer worry about odor or ruining my clothes. I use it every day like a deodorant. — J.G.
ANSWER: OK, J.G. I’ll let people know about your success. I am positive it will not hurt anyone. I’m not positive it will help everyone.
Thank you for supplying a different approach to a problem shared by many.
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.