DEAR DR. DONOHUE: After finally seeing a doctor and having many blood tests, I now have seven to eight bowel movements a day. Before I saw the doctor, it was only four. I am tired and disgusted, as this has been going on for years. — M.T.

ANSWER: You don’t need a doctor for your diagnosis. You can make it. It’s chronic diarrhea. You do need a doctor to find the cause of your problem. That’s a daunting task. The causes of chronic diarrhea are myriad. Acute diarrhea, diarrhea lasting a week or so, almost always is due to germs — viruses, bacteria or parasites. Chronic diarrhea can be caused by microbes, but it also has other causes.

You have had blood tests, but how about stool tests? Infectious organisms can be recovered and identified from a stool specimen. Furthermore, the stool can be checked to see if you are suffering from malabsorption, the inability to extract nutrition from food, another cause of chronic diarrhea.

Problems with the endocrine glands — the thyroid and adrenal glands — produce chronic diarrhea.

A scope inspection of the colon identifies things like ulcerative colitis and Crohn’s disease.

A biopsy of your colon reveals information that can be most helpful in determining a cause. Two illnesses with names unfamiliar to many people but familiar to many patients are collagenous colitis and lymphocytic colitis. A tissue specimen is needed to discover them. Both produce watery diarrhea.

While this search is progressing, your doctor might try out medicines used to slow down the transit of food in the intestinal tract. Loperamide (Imodium) or diphenoxylate with atropine (Lomotil) often can stanch the flow. If they cannot, codeine or tincture of opium, used for a brief period, can.

It’s time for you to see a specialist, a gastroenterologist.

DEAR DR. DONOHUE: My 72-year-old husband, who had high blood pressure, had not smoked for 24 years and was a recovering alcoholic for 26 years. He was very active and saw his doctors — a primary care doctor, a cardiologist and urologist — regularly. He had been a police officer and carried a gun on his left hip for 31 years.

He started having pain in his hip and put up with it for seven months. His primary care doctor ordered a scan, and it was downhill from there. He died three months later of renal cancer. I never asked his doctors why this wasn’t found before it was too late. I don’t understand why. I hope you have an answer for me. Did wearing the gun have anything to do with it? — B.B.

ANSWER: You have my sincerest condolences on the unexpected death of your husband. Around 51,000 cases of renal (kidney) cancer occur every year in the United States. The common signs of renal cancer include flank and abdominal pain. The flank is the side of the body between the lowermost rib and the area above the hip. Other signs are blood in the urine, weight loss and fever. I believe that his hip pain threw the doctors off. It’s not a common indication of kidney cancer. Perhaps an earlier discovery would have saved your husband’s life. I can’t say for sure. Some kidney cancers progress so rapidly that making an early diagnosis is impossible. Wearing a gun on his hip did not contribute to causing the cancer.

DEAR DR. DONOHUE: You wrote about Huntington’s chorea. Years ago, my mother told me that I had had chorea before I went to school. I am 87 now. When going through family papers I found a notation about my chorea. We have two married children. I would appreciate any more information you can give on chorea so that I can pass it on to my children if necessary. — S.K.

ANSWER: “Chorea” is a Greek word that means “dance.” Illnesses in which uncontrolled movements of the limbs are a prevalent feature are often given the name “chorea.” Huntington’s chorea is an inherited illness in which chorea-like movements develop and stay. You did not have it. I bet you had Sydenham’s chorea, a sign that sometimes appears with rheumatic fever. The strep germ is the cause of it. You do not pass this illness to your children. The chorea doesn’t remain. It goes away completely.

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.

Copy the Story Link