DEAR DR. DONOHUE: Through a CT scan, I have been diagnosed with extensive diverticular disease. You’ve mentioned that a lack of fiber as the cause. All my adult life, I have eaten whole-wheat bread, lots of fruit and vegetables, and plenty of fiber. I can’t remember ever being constipated. I was shocked by the diagnosis. My maternal grandmother finally succumbed to it. Could I be genetically predisposed to it? Would eating yogurt containing live bacterial cultures provide any value? – B.S.

ANSWER: A diverticulum is a small bulge on the outer colon wall. It’s smaller than a small grape, being only about .4 inches (1 cm) in diameter. What’s bulging is the lining of the colon. High colon pressure pushes the colon lining through the colon’s muscle wall and onto its outer surface. In societies where grains are refined and where fiber is scant, diverticulosis is rampant. The colon has to generate great force to move along undigested, hard and dry waste matter. Fiber keeps stool soft and moist. I can’t explain why a fiber-conscious person like you developed extensive diverticulosis. I suppose there might be a genetic predisposition.

To give you an idea of how widespread diverticulosis is, 50 percent to 70 percent of the elderly population has it.

Keep in mind that most people with diverticulosis – 70 percent – never suffer a single symptom. If the diverticula become inflamed, then the condition is diverticulitis, and that is painful. Pain usually arises in the left, lower side of the abdomen, where most diverticula are found. People are feverish, lose their appetite and feel nauseated, but they rarely vomit. With a more severe attack, the temperature is quite high, and the abdomen becomes very tender. Sometimes an attack of diverticulitis is signaled by painless rectal bleeding.

Treatment involves resting the digestive tract by taking only clear fluids and antibiotics. For more serious attacks, hospitalization with intravenous fluids and antibiotics is required. You may never face these possibilities. Most people with diverticulosis never do. Yogurt will not help.

The pamphlet on diverticulosis gives a more lengthy discussion of this topic. 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 haven’t seen anything in your column about fungus foot infection. We have several family members who have it on their toes. How does it start, and what can be done for it? – Anon.

ANSWER: I have to believe you’re referring to athlete’s foot, the most common kind of fungal foot infection. Few people pass through life without an encounter with the fungi of athlete’s foot. The infection spreads through contact with shed skin that contains the fungus.

Fungi thrive in warm, moist environments. A change of socks twice a day and wearing an alternate pair of shoes on successive days keep the feet dry. Antifungal foot medicines abound and come as ointments, creams or lotions. It can take a month or more for results. After the skin has healed, continue to apply the medicine for another two weeks. If over-the-counter medicines – Micatin, Lotrimin AF and Tinactin are a few names – don’t put an end to the infection, prescription medicines can.

DEAR DR. DONOHUE: When you are obese and then lose weight, how does fat leave your body? Does it go through the digestive system? Does it pass through your gallbladder, liver or kidneys? I recently lost quite a bit of weight through hard work. I have had two attacks of digestive distress since I began to lose the weight and wonder if they were gallbladder attacks. My husband says the fat fairy puts weight on and takes it off. I was looking for a more scientific explanation. – M.B.

ANSWER: Fat is a fuel, just like the gasoline in your car’s gas tank. When we need energy to power physical movement, much of the energy for it comes from fat. Carbon dioxide is one byproduct of fat-energy burning, and we exhale that. Other byproducts leave in the urine. We also burn stored fat when we reduce our calorie intake.

Rapid weight loss can lead to gallstones and gallbladder attacks. How quickly did you lose the weight?

I like your husband’s explanation. It’s poetic and mystical.

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.