DEAR DR. DONOHUE: I would like some information on celiac disease. I am healthy for my age. — L.P.

ANSWER: Not so long ago, celiac disease was considered an unusual illness; it’s anything but. Doctors now realize that it can appears without what were considered its classic signs — diarrhea and weight loss. Fatigue, easy bruising, anemia and osteoporosis at a young age are now recognized as possible celiac signs. It’s a malabsorption problem; nutrients in food can’t get into the bloodstream and the body.

The culprit is gluten, a protein found in wheat, barley and rye. People with the illness cannot tolerate gluten. Their immune system makes antibodies against protein. The digestive tract is thrown for a loop.

When diarrhea and weight loss occur, the diagnosis is relatively easy. When more subtle signs occur, the diagnosis is difficult.

The finding of celiac-caused antibodies in the blood provides useful information. One in particular, transglutaminase antibody, is a big tip that celiac disease is present.

Strict avoidance of gluten is the treatment. That means no wheat, barley or rye. That includes a considerable number of things eaten daily. Oats usually are off-limits in the early weeks of treatment. It’s impossible for people to learn on their own what is permitted and what’s not permitted for celiac patients. One, two or three sessions with a dietitian are mandatory.

Response to a gluten-free diet is fairly rapid. About 80 percent of celiac patients note a marked improvement within a month of adopting this diet. If you do turn out to have this illness, your doctor will refer you to a dietitian.

The Celiac Sprue Association is a source of valuable information and guidance. You can contact the association at www.csaceliacs.org. If you don’t have a computer, a friend or relative can come to your aid, or the local library will help you make the connection. The association’s phone number is 877-CSA-4-CSA.

DEAR DR. DONOHUE: I am an 81-year-old man in excellent health. However, I have trouble getting restful sleep because I have to get up so many times during the night — three to six times a night — to urinate. Do you have any suggestions? — J.B.

ANSWER: For an 81-year-old man, the most common reason for frequent nighttime trips to the bathroom is an enlarged prostate gland. The big gland makes it impossible for the bladder to completely empty. The bladder refills with urine quickly, and a signal goes out to visit the bathroom again.

Your family doctor can detect the problem and start you on medicines that often alleviate this problem.

The booklet on the prostate gland discusses enlargement and cancer. Readers can obtain a copy by writing: Dr. Donohue — No. 1001, 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 am a 76-year-old female. I have been miserable for two years with muscle pain and weakness. I recently was diagnosed with polymyalgia rheumatica and put on 20 mg of prednisone. I was feeling better. The dose was cut to 10 mg, and I feel terrible again. Any suggestions? — F.F.

ANSWER: My suggestion is to go back to the 20 mg dose after discussing it with your doctor. Polymyalgia is a common illness in older years, and consists of muscle pain and stiffness. The neck, shoulders, lower back, hips and thighs are the areas mostly affected. Prednisone — one of the cortisone drugs — usually controls symptoms quickly. However, when an attempt is made to cut the dose of prednisone, the symptoms often come back in full force. Upping the dose usually will take care of its recurrence.

It can take up to two full years to get off medicines.

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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