DEAR DR. DONOHUE: My husband is 75 and has inflammation of his intestines. The treatment he is on is no good, and he’s about ready to give up. For the past seven months, he has not been able to leave the house because he cannot be away from the bathroom. Sometimes there is blood in the diarrhea, and sometimes it’s all blood. He takes Asacol, which made a difference at first but now doesn’t. Is there any other treatment for this condition, and is there a specialist in this field? – J.M.

ANSWER:
I have to infer from what you said that your husband has inflammatory bowel disease. There are two such illnesses: ulcerative colitis and Crohn’s disease. Your husband’s bloody stools suggest that his illness is ulcerative colitis. With it, the large intestine (the colon) has many surface ulcers on its lining that bleed. In addition to bloody diarrhea, crampy abdominal pain is common. There are two peak age categories for this illness. One occurs between the ages of 15 and 30, and the second between 60 and 80.

An examination of the colon with a scope establishes the diagnosis. Has he had such an exam?

There are many more medicines for ulcerative colitis besides Asacol. If it’s not working, he should be on something else. If medicines fail, then consideration is given to removing the colon. That usually puts an end to the problem.

Your husband should see a gastroenterologist. That is the doctor who is an expert in this field. He should see one soon.

DEAR DR. DONOHUE: I take Lipitor for my cholesterol. I am uneasy about taking it. The doctor says it can cause liver damage, so I have to have my blood checked every three months or so.

Can’t I lower my cholesterol by watching what I eat? How common is liver damage from Lipitor? – D.D.

ANSWER:
Yes, you can lower your cholesterol by watching your diet. You should be doing that even when you take a cholesterol-lowering drug. If you go on a very Spartan, vegetarian diet, you can often greatly lower your cholesterol. Not many can stay on such a diet, but a modified diet that has lots of fruits, vegetables and grains can also bring down the cholesterol number.

It’s not so much high-cholesterol foods that boost blood cholesterol; it’s fatty foods that do so, especially saturated fat, the kind of fat that marbles meat and the kind found in whole dairy products. Saturated fats prod the liver into making cholesterol. Most of our cholesterol is our own liver-made cholesterol. Trans fats do the same. The amount of trans fats in food now appears on food labels. Trans fats are found in many products, like commercial baked goods.

Statin drugs – Zocor, Lipitor, Crestor, Lescol, Pravachol and Mevacor – are the most powerful cholesterol-lowering drugs available. They stop the liver’s cholesterol output.

They can cause liver and muscle damage, but they rarely do so. Millions of people take these drugs. You’re not on the edge of a precipice with someone behind you pushing on your back. If there is any evidence that the liver is suffering, stopping the drug stops liver damage.

DEAR DR. DONOHUE: I am 71, and I have high cholesterol. I read in a magazine that if I drink pomegranate juice, it will help reduce my cholesterol. Is there any truth to this? – E.C.

ANSWER:
Pomegranate juice has become the latest nutritional darling. Many say it can stop LDL cholesterol from clinging to arteries. That’s the kind of cholesterol that plugs arteries and obstructs blood flow through them. It’s also been championed as being good for macular degeneration and some cancers.

I don’t have evidence to support all these claims. I don’t have any evidence that the juice would hurt you either. Experiment a little. Start drinking it and see what happens to your cholesterol. Let me know the results.

One remote possible side effect of pomegranate juice is that it might increase the blood level of statin drugs, like Lipitor. To play it safe, tell your doctor what you’re doing.

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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