DEAR DR. DONOHUE: I wonder if you can help me. I served as a sergeant in the Canadian army in World War II. I receive a small pension for the lasting effects of rheumatic fever, which kept me in the hospital for many months during my tour of duty. I now have arteriosclerotic heart disease. Is there any connection to the rheumatic fever I had while in the army? I have to have some evidence to present to veterans affairs for coverage. – E.C.

ANSWER: As much as I would like to help you out, I can’t find any information that supports a connection between rheumatic fever and arteriosclerotic heart disease – the common heart condition where heart arteries become clogged with a buildup of fat, cholesterol, blood platelets and some blood proteins. If the buildup keeps enlarging, it can completely block blood flow to heart muscle and lead to a heart attack.

Rheumatic fever follows a strep sore throat. It’s the reason why strep throat is treated. A strep throat infection will most often clear up without treatment, but the longer the strep germ is in the throat, the greater the possibility of coming down with rheumatic fever.

During an episode of that illness, joints can swell and hurt. A red rash that looks like smoke rings can break out. Small bumps might appear under the skin. Some develop uncontrollable flailing movements of the arms and legs — chorea (core-EE-ah). All these disappear in time. There is one consequence of rheumatic fever that can become permanent – heart-valve damage. If you have a heart murmur and if the doctor says one of your heart valves is leaking or is narrowed, then you have grounds to blame that on rheumatic fever.

Penicillin, the usual treatment for strep throat, cures the sore throat and prevents rheumatic fever. It did not become widely available until after the war.

DEAR DR. DONOHUE: My 56-year-old brother recently had a routine colonoscopy that indicated ischemic colitis and diverticulosis. I understand what diverticulosis is, but I have no knowledge of ischemic colitis. He has no symptoms. I would appreciate any information on ischemic colitis. – K.M.

ANSWER: Ischemia (is-KEY-me-uh) is a constantly used word in medicine. It means there is a blockage of blood flow through an artery that deprives the area served by that artery of nutrition and oxygen. Coronary-artery heart disease, the condition where one or more heart arteries have filled with cholesterol and other gunk, is also called ischemic heart disease.

Ischemic colitis is a blockage in one of the arteries that deliver blood to the colon. It can cause stomach pain and the passage of bloody stool.

If the blockage is in an artery that serves only the colon lining and if the involved area is small, there might not be any symptoms. This kind of ischemic colitis is often transient, and recovery is usually complete. One reason why this is so is that blood can take alternate routes in reaching the colon.

On the other hand, if the blockage is extensive, then the consequences cannot be taken lightly. The involved section of colon can die, and feces can spread throughout the abdominal cavity to cause a life-threatening infection.

Your brother must have a slight degree of ischemia. If it were serious, his doctor would have warned him and would have done something about the condition.

DEAR DR. DONOHUE: About a month ago, I started feeling pain in my knees, and my doctor prescribed Mobic. Instructions given to me say not to take aspirin or alcohol while using it. Why? – S.G.

ANSWER: Mobic is a nonsteroidal anti-inflammatory drug. These drugs can irritate the stomach and can cause ulcers and bleeding. Aspirin and alcohol can also irritate the stomach. Their action, along with the action of Mobic, is asking too much of the stomach. It’s a bit like inviting an ulcer to form. That’s why the warning is given.

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.