DEAR DR. DONOHUE: For the past two years, I have had a dry mouth that’s getting worse. My doctor tells me to drink water and I do, but it doesn’t help. Now my eyes are dry. I have to blink constantly because I feel like there’s something in them; there isn’t. What’s going on? – L.T.

ANSWER: Many conditions cause the mouth or the eyes to dry. When the two happen simultaneously, then Sjogren’s (SHOW-grins) syndrome springs to mind. Dr. Henrik Sjogren, a Swedish doctor, described it in 1933. It’s not a rarity. It can happen to anyone – men, women and children – and it can happen at any age, but it most often happens to middle-age women. The immune system attacks tear and saliva glands.

Lymphocytes, one kind of white blood cells, infiltrate those glands and put them out of commission. Dry eyes make people feel like there’s grit under their eyelids. A dry mouth makes it hard to chew, difficult to swallow and impossible to think about anything other than getting something wet into the mouth. A dry mouth also sets the stage for tooth decay.

Eyes and mouth don’t have to be involved at the same time. At first, it might be just the eyes or just the mouth.

In a few instances, Sjogren’s is part of a bigger picture, like rheumatoid arthritis, lupus, scleroderma (hard skin) or hepatitis. On its own, Sjogren’s can cause its own peculiar kind of arthritis.

For dry mouth, a plastic squeeze bottle filled with water ought to be your constant companion. Sugarless chewing gum keeps the mouth moist. Salagen and Evoxac, two prescription medicines, promote saliva production. Numoisyn Liquid is a new artificial saliva.

Wraparound glasses protect the eyes from wind and keep them moist. Restasis is a newer eyedrop that aids in tear formation. Doctors can seal tear ducts to keep the eyes from drying.

Have your doctor confirm this suspicion and contact the Sjogren’s Syndrome Foundation at 1-800-475-6473 for the latest on this condition. The foundation’s Web site is: www.sjogrens.org.

DEAR DR. DONOHUE: I scrub my face four or five times a day, and still I have acne. I eat candy and love french fries. Could they be the cause? What else can I do? I am 15. – B.M.

ANSWER: Stop scrubbing your face so much. You aren’t helping matters. You’re promoting more pimples. Gently wash twice a day with a mild soap. That’s enough.

Foods don’t cause acne – that includes candy, chocolate and fried foods. If you can definitely trace an acne outbreak to a particular food, then avoid that food, but such a link is almost never found.

Drugstore shelves are filled with acne medicines. Start with one that contains benzoyl peroxide. Use it for at least six weeks. No medicine gets rid of pimples that are already on the face. Medicines prevent new pimples from forming, and that takes about six weeks.

If you’re not having any luck with this program, see your family doctor or a dermatologist for stronger medicines that are available only with a prescription.

DEAR DR. DONOHUE: I am ashamed to admit it, but I used to snort coke. I haven’t done it for three years, and I no longer have any urge to use it.

I heard a whistling sound in my nose, and I have discovered a hole in the partition between my right and left nostrils. Should I get this fixed? – D.K.

ANSWER: That partition is the nasal septum. It’s made of cartilage. Snorting cocaine often leads to a perforation through the cartilage. If the hole is small, it can be left alone. If it causes nosebleeds, it should be fixed. If it’s very large, the nasal septum can collapse and be quite disfiguring. Large holes definitely need repair.

Have your doctor take a look at this. You need a one-on-one exam for a definite answer.

DEAR DR. DONOHUE: I have a continuing siege of bladder infections. My doctor treats me with antibiotics, and I am good for a while, but then the infections keep coming back. Now I am on nitrofurantoin, and I will stay on it a long time. Will this make me insensitive to other antibiotics? – R.B.

ANSWER: Women are disposed to bladder infections because their urethra (the tube emptying the bladder) is much shorter than men’s, because the urethra’s opening is in a place with an abundance of bacteria, and because the urethra’s lining, after menopause, thins and dries out. There are steps to take to prevent these infections.

A relapsed bladder infection is one that comes back within two weeks after treating the first infection. Relapsed infections are usually due to the same germ that caused the first infection. A relapse can indicate that the duration of therapy has to be longer, that the bacterium has developed resistance, that there might be an infection in the kidneys or that the woman might have an undiagnosed kidney stone.

A recurrent infection comes back more than two weeks after completion of treatment. It usually is due to a different bacterium, one requiring a different antibiotic.

The first thing to do for both is to culture the urine to see what antibiotic the bacterium is susceptible to. Women with this problem should urinate after having intercourse to flush bacteria from the urethra. Some doctors give these women an antibiotic to have on hand so they can initiate treatment quickly at the first sign of infection. Susceptible women need to drink lots of fluid to wash away bacteria from the urinary tract. Another gambit is to stay on a low dose of an antibiotic like nitrofurantoin for a long period to suppress bacterial growth. That doesn’t make a woman insensitive to other antibiotics.

Cranberry juice can help keep the urine bacteria-free. It’s not an old husband’s tale.

The booklet on urinary tract infections gives the full story on this topic. To obtain a copy, write: Dr. Donohue – No. 1204, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6.75 Can. with the recipient’s printed name and address. Please allow four weeks for delivery.

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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