DEAR DR. DONOHUE: I am a female, 78, 5 feet 10 inches tall, weighing 155 pounds, active and in good health – or so I thought. I eat right and never smoked or drank alcohol. Yesterday, a colonoscopy showed severe diverticulosis. The doctor prescribed Benefiber, then left and never returned.

I am stunned. What do I do now? Will I have this forever? Am I unhealthy? How does one develop diverticulosis? What the difference between “osis” and “itis”? – S.K.

ANSWER:
Your world isn’t collapsing. You’re healthy. You’ll have diverticulosis forever. By age 60, half of the people in North America have it. By age 80, two-thirds have it. A diverticulum is a bulge of the inner colon lining through the colon’s muscular wall to its outer surface. A diverticulum looks like a small soap bubble. It’s only 1/5 to 2/5 inches (0.5 to 1 cm) in diameter. You can thank our diet for diverticulosis. We refine flour and throw away its bran – the outer coat of grain. In countries where whole grains (including the bran) are commonly used, diverticulosis is a rarity. Bran and other fiber hold water in undigested food. Without fiber, the food residue dries and becomes hard. The colon muscles have to generate a great deal of force to keep it moving. That force causes the colon lining to pop through the colon wall as a diverticulum. For most, diverticulosis is a silent condition that remains silent for life.

For a few, the diverticulum breaks and causes a local infection in the colon – diverticulitis. The pain of a diverticulitis attack is usually felt in the lower left corner of the abdomen, and sometimes people have fever and chills along with the pain. The attack is treated by resting the tract and by giving antibiotics.

We’re supposed to get 30 grams of fiber a day. Fruits (especially those with edible skins), many vegetables and whole-grain products are the source of dietary fiber. If people cannot get enough fiber in their diet, then commercial products like the one you’re taking fill the gap. Metamucil, Perdiem, Citrucel and Fiberall are other examples.

The booklet on diverticulosis explains the ins and outs of this very common disorder. To order a copy, write: Dr. Donohue, No. 502, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6 Can. with the recipient’s printed name and address. Please allow four weeks for delivery.

DEAR DR. DONOHUE: I need input on a problem I have. My urea nitrogen is 21, and my creatinine is 1.1. Also, my RDW is low at 11.3. How did all of this come about? – S.A.

ANSWER:
Nothing bad has come about. Everything is fine. Blood urea nitrogen and creatinine are blood tests that measure kidney function. A normal creatinine is less than 1.5 mg/dL. You’re great. The upper limit of normal for blood urea nitrogen – BUN – is 20 mg/dL. You’re 1 mg over. That’s no big deal. The BUN is affected by many things, and a high-protein meal prior to the test can elevate it.

RDW is red blood cell distribution width. A value less than 14.5 is normal. You’re quite normal here too.

DEAR DR. DONOHUE: Can you give me insight into the Hamman-Rich syndrome? My father passed away from it. – L.R.

ANSWER:
I can tell you only a little, because only a little is known about it. It’s a lung injury that comes on suddenly, with damage to the lung air sacs (the alveoli) and the spaces between the air sacs, the interstitium. The cause is unknown. Because of such destruction, oxygen cannot get into the blood. Patients are severely short of breath, have a fever and they cough. The only medicines are ones to keep the person going as best as possible. There is no cure medicine. Even with a ventilator, death happens to more than 60 percent of these patients.

It’s an illness that reminds doctors that they don’t have an answer for every malady.

You and your family have my condolences.

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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