DEAR DR. DONOHUE: In October I had surgery for a blocked colon caused by adhesions from a previous colon surgery in 1999. I was told it might happen again.

My understanding is that adhesions in the colon are like the rough inside of a pipe. They hold up the waste products and produce a blockage.

Should I restrict my diet to soft and liquid foods? What about gummy foods, such as pasta, bread, potatoes and peanut butter. Would a vegetarian diet be better than one that includes meat? – E.H.

ANSWER: Your picture of adhesions is a bit out of focus. They are bands or strands of scars that form within the abdominal cavity after abdominal surgery. They can also occur because of endometriosis, intra-abdominal infections and things like appendicitis.

The scar tissue can wrap itself around the small intestine or the colon and squeeze it. The squeeze might be so constricting that it obstructs the passage of undigested food through the intestines. That’s painful and can be a serious problem.

Surgeons cut the adhesions and free the intestine from the encircling strands of scar tissue.

Diet has nothing to do with their formation. Soft, liquid or gummy foods won’t prevent them. Neither will a vegetarian diet. There is little a person can do to prevent a recurrence. It happens to about 20 percent to 30 percent of patients. Looked at in a brighter light, it doesn’t happen to 70 percent to 80 percent.

DEAR DR. DONOHUE: I am an 85-year-old male who is doing fine after a heart attack six years ago. My problem is dehydration. I had to go to the emergency room four years ago because of it. They fixed me up fine and released me. Their comment was, “Another few minutes, and you would have been dead.”

I urinate too often during the night, and sometimes it makes me dehydrated, dizzy, weak. I drink Gatorade, and it clears up.

No one can tell me what to do about this scary problem. Can you help? – L.R.

ANSWER: First, establish that it is dehydration that’s the cause of your symptoms. Buy an inexpensive, plastic container that looks like a slender milk carton and holds a full quart of fluid. One side has markers for ounces, and the other side has markers for milliliters. Rubbermaid makes such a container, but I am sure there are other brands.

For one whole week measure how much urine you put out both during the night and during the day. It would be very scientific if you would also keep a record of all the fluids you drink in 24 hours. Then you or your doctor can see if there really is a difference in the amount of fluid you take in and the amount you put out. If that is the case, dehydration is a valid explanation. The next thing is determining why you put out so much urine. There are a number of conditions that cause it, and most of them have a treatment.

If, on the other hand, you urinate frequently at night but put out only small amounts of urine, then the problem is more likely to be an enlarged prostate gland that keeps you from completely emptying your bladder. The dizziness and weakness might come from interruptions of your sleep. There are many solutions for an enlarged prostate — medicines and surgical.

Readers respond to colonoscopy pain or lack thereof:

“I had no problem with the test or afterward, and I had it without any sedation.” B.O.

“The thought of the procedure freaked me out. I finally got one, and it was a piece of cake.” S.D.

“I will never have another colonoscopy. During the procedure I had pain and cramps and screamed. Instead of abandoning this torture, the nurse lay across me and held me down until it was over. You tell me if I have a distorted picture or if this is patient torture.” P.T.

The letters saying colonoscopy was nothing far outnumbered those that complained about it. I can’t explain why some had such a hard time. Maybe it’s physician technique or people’s peculiar anatomy. At any rate, the test is necessary.

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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