Cirrhosis swells abdomen
DEAR DR. DONOHUE: From my earliest days until five years ago, my dad drank a couple of six packs of beer every day. I am now 30. He wasn’t an abusive father, but his drinking made life difficult for us. He is now 75 and hasn’t had a drink for five years. I visited him the other day and was shocked by what I saw. His stomach is huge, and I know it’s not from overeating. Is this due to his past drinking? — H.L.
ANSWER: It probably is. I imagine he has liver cirrhosis. Cirrhosis is thick bands of scar tissue crisscrossing the liver. The liver can’t carry on its many functions — protein production, detoxification, glycogen storage, regulation of cholesterol and fats, synthesis of blood-clotting factors and making bile. The scar tissue raises the pressure of blood in the liver’s and abdomen’s blood vessels. That causes fluid leakage into the abdominal cavity. A lack of protein in the blood adds to that fluid leakage. A cirrhotic liver promotes sodium and water retention, which is another factor in fluid accumulation.
Other complications result. The veins that line the lower part of the esophagus dilate and become fragile. They bleed easily, and hemorrhage from those veins can be deadly.
Your dad needs to be under a doctor’s care, if he isn’t already. The doctor will decide if your father needs treatment for dilated esophageal veins and if he needs interventions to slow the abdominal retention of fluid.
No medicine can reverse far-advanced cirrhosis. Liver transplantation is the only cure. The supply of livers is frustratingly small.
DEAR DR. DONOHUE: What can I do about having too much ear wax? I know when it’s happening, because I can’t hear well. I have to see the doctor at least twice a year to remove the wax.
How can I take care of this myself? — A.H.
ANSWER: Ear wax plugging the ears is responsible for 12 million doctor visits yearly in the United States. A wax-filled ear canal not only interferes with hearing, but it can cause ear ringing (tinnitus), itching, infection and, believe it or not, a chronic cough.
Don’t use a cotton-tipped applicator to remove the wax. Applicators push the wax deeper into the ear canal.
Soften the wax with a few drops of warm water or warm (not hot) mineral or vegetable oil. Keep the head bent for 10 minutes to one side after instilling the drops, then let the liquid drain out. Or you can use one of the many wax softeners available in all drugstores. A couple of names are Earigate and Debrox. Follow the directions carefully.
After softening the wax, gently flush the ear with warm water, using a bulb syringe, also available in drugstores.
Self-treatment works sometimes, but not always. If you have difficulty with it, don’t force the issue. Continue to let the doctor remove it for you. Doctors have the advantage of seeing what they’re doing, and they have instruments that facilitate wax removal.
Ear wax has useful properties. It keeps the ear canal moist, and it serves as a barrier to bacteria and yeasts. Wax is propelled out of the ear daily and unnoticeably by a sort of conveyor-belt process. Chewing enhances the natural removal of wax. Your conveyor belt might not be up to snuff, but I don’t know any way to get it working better.
DEAR DR. DONOHUE: I am concerned about my feet. I feel like I am walking on marbles. It’s the same whether I am in shoes or barefoot. My doctor doesn’t know what causes it. I would really appreciate and answer. — H.E.
ANSWER: I’m not positively sure, but peculiar feet sensations, like the ones you describe, often can come from nerve malfunction — neuropathy. Ask your doctor if you might possibly be suffering from peripheral neuropathy. A neurologist is the doctor to see if that’s what you have.
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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