DEAR DR. DONOHUE: I had a bladder stone three years ago. It was lasered and removed. The following year, I had two stones, and they were removed. It’s now been three years, and again I have a single stone. My doctor doesn’t submit these stones for analysis. I asked what causes them, so I can modify my diet if necessary. He informs me that he doesn’t know. He also said it may be caused by my enlarged prostate. I have taken Flomax for four years. Can diet prevent these stones? — L.P.

ANSWER: Bladder stones are much rarer than kidney stones. They’re not related to kidney stones in any way. Most often, they arise because urine can’t get out of the bladder easily. It stagnates there. That creates a situation that permits mineral crystals, dissolved in the urine, to settle out of the urine and aggregate into a stone or stones. Your doctor has suggested that your enlarged prostate gland is the reason why you form stones. The gland blocks the free flow of urine out of the bladder. Enlarged prostate glands are one reason why men so outnumber women as bladder stone formers.

Urinary bladder infections are another cause of such stones.

You do face a dilemma. The best way to prevent bladder stones is not so much dietary as it is staying hydrated and keeping the urine diluted. You have to increase your intake of liquids. That will, however, because of your large prostate gland, keep you running to the bathroom frequently.

Many procedures can reduce the size of the prostate gland, and some of them can be done in the doctor’s office. Why not discuss with your urologist one of these less-invasive ways of downsizing the prostate?

TO READERS: Dizziness is a concern of many people, especially older people. The booklet on that topic delves into its causes and treatments. To order a copy, write to: Dr. Donohue — No. 801, 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 was just diagnosed with polycythemia and was told that there is no cure for it. While looking on the Internet, I found claims that Chinese herbal medicines can cure it. Do you think there would be any harm in my trying one of these herbs? — R.A.

ANSWER: You have to give me the name of the herb. Not all herbs are without side effects, and some interfere with other medications. I can tell you that no herb has been approved by medical scientists for the treatment of polycythemia, an illness in which the bone marrow produces too many red blood cells, white blood cells and platelets. Without treatment, survival in polycythemia is measured in months. With treatment, survival extends to 10 and more years.

Treatment for polycythemia is periodic removal of blood. If blood removal doesn’t control the illness, then the medicine hydroxyurea can. I’d end your practice of surfing the Internet for treatments and see about taking the more standard, proven ways to contain polycythemia.

DEAR DR. DONOHUE: I am a 57-year-old woman with diabetes and gout. My doctor advises his patients to take fish oil capsules. When I asked about them having high purine content, he didn’t have an answer for me. High-purine foods are off a gout person’s diet. What can I take? — J.P.

ANSWER: Purines are the precursors of uric acid, the material responsible for gout. Formerly, the only gout treatment was a diet that excluded purine foods: organ meats (liver, brain, kidney, sweetbreads) sardines, anchovies, mackerel, veal, turkey, gravies and bouillon. Now, with effective medicines, super-strict diets are not imposed.

I can’t find purines listed on the content label of fish oils — at least the ones I read. I do see anchovies and sardines mentioned. That might be the purine source. I can’t believe a capsule contains much purine. If you want to experiment, take the pills for two weeks and then have your uric acid checked.

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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