DEAR DR. DONOHUE: For the past six months I have had constant diarrhea and stomach cramps. I lost more than 25 pounds and almost lost my job because of absenteeism. Finally I saw a gastroenterologist, who diagnosed me as having Crohn’s disease. There are still some questions I need answers to. Is it curable? Does it shorten life? – K.K.

ANSWER:
Crohn’s disease and ulcerative colitis are the two inflammatory bowel diseases. Inflammation of the digestive tract is common to both, but aside from that, they are distinct illnesses.

Crohn’s can attack any part of the digestive tract from the esophagus to the colon. Ulcerative colitis, on the other hand, is limited to the colon – the large intestine. The inflammation in Crohn’s disease affects all layers of the digestive tract. With ulcerative colitis, the inflammation remains on the most superficial layer of the tract.

One of Crohn’s major symptoms is crampy stomach pain. The pain worsens after eating. Diarrhea is a prominent feature, and the diarrhea often is at its worst during the night. Rectal bleeding, night sweats, fever and weight loss are some of its other calling cards.

Medical science is still ignorant of its cause, but the immune system appears to be involved, and that bit of information comes into play in devising medicines for it.

Crohn’s is not curable. Most often, however, it is controllable.

Azulfidine, Dipentum, Asacol and Pentasa are but a few of the medicines that can keep Crohn’s under wraps. Doctors turn to the cortisone drugs when the illness doesn’t respond to the above medicines, but they use them for only a short time. Their side effects can be formidable. Azathioprine and mercaptopurine, two drugs that target the immune system, are effective treatments. The latest member of the Crohn’s drug family is infliximab. It is given by intravenous infusion.

Crohn’s disease does not shorten most patients’ life spans.

DEAR DR. DONOHUE: At age 19 I was treated for genital warts. I am now 30 and have never had another outbreak. My Pap smears always come back normal. What’s up? I thought outbreaks keep coming back. – W.W.

ANSWER:
It’s odd to hear someone write of his or her good fortune. Don’t worry that things are going your way. Sometimes life can be better than it is made out to be.

Contrary to previous popular teaching, genital warts might not always be a lifelong battle. Papillomaviruses are the cause of genital warts. Many people infected with the virus stay infected for long times, even for life. On the other hand, there are some fortunate people who have only one outbreak of genital warts. The virus goes away. Don’t ask why or how. Accept the fact thankfully.

You have had no sign of the virus for 11 years. Stop worrying. It’s not going to come back.

The pamphlet on herpes and genital warts contains current information on these two common problems. Readers who would like a copy can obtain one by writing: Dr. Donohue – No. 1202, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.50 U.S./$6.50 Can. with the recipient’s printed name and address. Please allow four weeks for delivery.

DEAR DR. DONOHUE: I am a 30-year-old woman who is making a career change. I have a degree in computer programming, but I cannot find a job. I entered the field because of its supposed job security. I am now in training to be a nurse, and I find I like it much better than computers.

My mother has me worried. She tells me I never had chickenpox. She thinks I should get the chickenpox vaccine since I am going to be a pediatric nurse. Can adults get the vaccine? – W.B.

ANSWER:
Yes, adults can get the chickenpox vaccine. For adult immunization, two shots are given, with a one- or two-month interval between the first and second shots.

Pregnant women should delay getting the vaccine until they have delivered. The chickenpox shot contains living virus.

Your mother’s idea has much merit. It would be wise for you to get the shot.

DEAR DR. DONOHUE: I am a 79-year-old woman. I am active and feel fine but have a bruising problem. My arms are sometimes covered with bruises. My neighbor says it could be a vitamin deficiency. If so, which one? — R.D.

ANSWER: A bruise is blood that has leaked from a broken vessel close to the skin’s surface. A black eye, for example, is a bruise in the extreme.

Some serious causes of bruises include a deficit of platelets or a deficit of clotting factors.

Platelets are blood cells that act like corks. If a blood vessel breaks, platelets rush to seal the break. A simple blood test tells if platelet numbers are low.

Clotting factors are blood proteins. They work hand in hand with platelets to stop bleeding. The lab can identify a clotting factor deficit without a big fuss.

Most often, however, in someone your age, bruises result from surface blood vessels that have become fragile with the passing years. In addition, tissues that surround and cushion blood vessels have thinned.

There is not much you can do to stop the bruises that are common with age aside from being careful not to bang your arms, even lightly. Forty-eight hours after a bruise appears, warm-water compresses can speed its disappearance.

Play it safe. Tell your doctor about your bruises. Then you and the doctor can make a decision on how aggressively you should pursue the matter.

Vitamin deficiencies can cause bruising. The two involved vitamins are C and K. In this part of the world, deficiencies of vitamins C and K are almost unheard of.

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.


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