DEAR DR. DONOHUE: My husband expired from his large intestine being kinked and twisted. The death certificate said it was volvulus. Will you write an article on this?

Let me know the cost, and I will send you a check. — V.M.

ANSWER: The cost is the stamp you put on your letter.

Picture one of those elongated balloons that, when inflated, look a lot like a huge sausage and can be maneuvered into a variety of shapes. The colon (the large intestine) resembles that kind of balloon. Volvulus is a twisting of the colon. The twist obstructs it. Gas and undigested food can’t get through. Furthermore, the twisting shuts down blood flow to the twisted section. That brings about gangrene, death of the involved part. This is something that happens mostly to older people, people in their 60s and 70s. Chronic constipation may play a role.

A sudden onset of abdominal pain is one sign of volvulus. The trouble is that many other conditions present with sudden abdominal pain.

X-rays or abdominal scans can furnish valuable information on what’s happening in such a situation. The immediate treatment involves inserting a soft tube through the rectum to untwist the colon, unblock the pent-up, undigested food and gas, and re-establish blood flow. If this procedure isn’t successful, then surgery is the answer. Surgery often is the preferred treatment, since it prevents a recurrence.

If the section of involved colon has died, the prognosis is grim. The death rate is as high as 60 percent.

You have my sincerest sympathy on the death of your husband.

DEAR DR. DONOHUE: Can you give me some information on a condition where a person pulls his or her hair out? Is it nerves, or is it something the person lacks? — E.B.

ANSWER: That’s trichotillomania, a compulsion to pull out hair, usually scalp hair, but eyebrows and other hair also can be a target. The majority of affected people are young women who begin to do this in their teens. Increased anxiety prompts hair plucking; doing so relieves tension. All of this goes on without a person realizing it. People can be doing something else, like reading or watching TV. The hair pulling can be so extensive that it produces bald patches.

Cognitive behavior therapy offers effective treatment. The therapist teaches the hair-puller how to recognize stimuli that provoke it and how to put an end to it. Medicines like antidepressants are prescribed, not to correct a depression but to restore normal brain chemistry, which often is involved in this disorder.

DEAR DR. DONOHUE: Is it wise to let a 6-year-old keep having strep throat without removing his tonsils? He has had six strep throats a year for about three years. The doctor doesn’t want to remove his tonsils. Couldn’t this affect his hearing or his kidneys? — B.M.

ANSWER: At one time, tonsillectomy was a rite of passage. These days it’s done infrequently. You must realize that every sore throat is not a strep throat. Strep throats can lead to rheumatic fever and kidney damage if they’re not treated with antibiotics. Ear damage isn’t all that common. Testing for strep is an important aspect of managing a sore throat.

One set of guidelines used to determine the necessity of tonsil removal as the following: If a child has had, in one year, seven or more sore throats, either proven or presumed to be strep sore throats treated with antibiotics, or had five or more such infections in the preceding two years, or had three or more in the preceding three years, then tonsillectomy is considered. Other guidelines suggest tonsillectomy with fewer infections.

The danger of a strep throat is it being followed by rheumatic fever. That happens only to a few and only to those who go untreated.

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.