DEAR DR. DONOHUE: I have such an itchy behind that it’s driving me crazy. I have been using a hemorrhoid cream, but it’s not working. This is more than a constant distraction. It’s social catastrophe. Can you give me any ideas for relief? – L.B.

ANSWER: I would like to give you one answer with one solution, but I can’t. There are many possible causes and many possible solutions.

Let’s start with dietary possibilities. Coffee and tea (and anything caffeinated), colas, beer, tomatoes, chocolate and citrus fruits have all been implicated as itch-causers by people. You have to keep track of what you eat and see if there is a particular food that’s influencing your itch.

Skin conditions like eczema and psoriasis are two of numerous skin conditions that can bring on an itch.

Loose stools, fecal soiling, an incompetent anal sphincter, improper cleaning and some toilet tissues are often identified as the reason for rectal itching.

Hemorrhoids, fissures (splits in the rectal lining) and even cancers can sometimes present as itches.

Start your attack on the problem by eliminating the foods and beverages I mentioned. Then go on a hygiene program by bathing after every bowel movement, if you can. If you cannot, get premoistened pads at the drugstore and use them in place of toilet tissue. Talcum powder will keep the area dry, especially in hot weather. An over-the-counter antihistamine can ease the itch, and it’s best taken at nighttime, as it can cause drowsiness. It’s important to resist the urge to scratch, since scratching adds to the irritation and intensifies the itch after the moment of relief from scratching has gone. Hydrocortisone cream – another item on the selves of drugstores – lessens inflammation and itching.

If none of this puts a stop to the problem, you’ll have to see the doctor. Some of the important causes require an examination. And the doctor can check for infectious causes of itching like pinworms and fungal infections.

DEAR DR. DONOHUE: Selenium has been recommended to me as a way to prevent prostate cancer. Both my dad and his father had it. Is it worth the money to get some and use it daily?

The same person who told me about it said prostate cancer rates were at an all-time high because there is too little selenium in our diets. Frankly, I have heard about selenium only in high-school chemistry classes. I never realized it’s something that we should eat. – B.F.

ANSWER: Selenium is a trace element, like copper and zinc. We need only tiny amounts of it. The recommended daily allotment for adults is 55 micrograms. A microgram is too small to be visible.

Selenium has a number of important functions. It preserves cell membranes and takes part in the synthesis of DNA.

Meat and seafood have a good supply of selenium. Vegetables, fruits and grains also have selenium, but their content depends on the selenium content of the soil where they were grown. I’m not aware of any selenium deficiencies in Canada or the United States.

Selenium has been promoted to prevent many illnesses, including lung, colon and prostate cancers. Those promises are based on animal studies. Animal studies are a long way from certainty when it comes to applying such information to humans.

For the present, I wouldn’t be swayed into overdosing on selenium. Stay within the accepted daily allowances until there is further information.