DEAR DR. DONOHUE: My mother, 79, was diagnosed with diverticulosis more than 10 years ago. Last year she experienced discomfort — abdominal pain and constipation, but no bloating, diarrhea or cramps. She saw the family doctor, who prescribed a stool softener and laxative. When this didn’t work, she saw a gastroenterologist. Based on my mother’s symptoms, he said she had lactose intolerance. For a year, she has followed a strict lactose-free diet. I told her she should be tested. But she never questions anything her doctors say. Common sense tells me that a diagnosis based solely on two symptoms that aren’t indicative of lactose intolerance isn’t enough evidence to follow a restrictive diet. — Anon.

ANSWER: At birth, our digestive tract has a good supply of lactase, the enzyme that digests milk sugar, lactose. That’s a good thing. We’re milk drinkers during those early years. With age, the supply of lactase declines, and many people become sensitive to milk and dairy products. They can cause gas, bloating, diarrhea and stomach pain. I wouldn’t have been able to make the diagnosis of lactase deficiency, also called lactose intolerance, only on your mother’s symptoms.

If there is doubt about the diagnosis, testing is strongly suggested. The hydrogen breath test is one such test. Bacteria in the digestive tract produce hydrogen gas when exposed to large amounts of lactose (milk sugar). If a person doesn’t have a supply of the milk-sugar enzyme lactase, dairy products pour lactose into the tract, and the bacteria go wild producing hydrogen. The amount of hydrogen in the breath is tested for its hydrogen volume after giving the patient lactose. A high reading indicates lactose intolerance.

Concern about total avoidance of dairy products, unless necessary, is justified. They are the chief sources of calcium and vitamin D. They have a good amount of potassium, phosphorus, protein, vitamins A and B-12 and riboflavin, another B vitamin. People who are taking in too little dairy need supplements of calcium and vitamin D. Or they can drink LACTAID milk, milk treated with the enzyme. Or they can buy the lactase enzyme in pill or tablet form and take those preparations before eating dairy products. Or they can go off their diet and see what happens.

DEAR DR. DONOHUE: Will you give me yes-or-no answers to my questions? 1. Does a deficiency of certain B vitamin(s) at conception sometimes result in birth anomalies? 2. Can the addition of fluoride to drinking water result in deficiency of essential trace minerals like iodine? — R.R.

ANSWER: OK, I can do that.

1.Yes. 2. No.

TO READERS: The booklet on restless leg syndrome and nighttime cramps gives a pretty exhaustive coverage of those two topics. Older people commonly suffer from one or the other or both. Readers can obtain the booklet by writing: Dr. Donohue — No. 306, 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 61-year-old male who is starting to get a turkey neck (excess flab) under my neck. Is there any exercise I can do to eliminate it or to tighten up the tissues? I would like to have this excess tissue pulled back toward my neck and chin without going through surgery.

Lately I have been doing situps hoping that they will help. Will they? — Anon.

ANSWER: I hate to ruin your day, but I know of no exercise, no diet, no vitamin and no mineral that will accomplish what you want. Surgery works, and it’s not all that involved.

Situps strengthen your abdominal muscles. If you do enough, they will burn calories. They won’t, however, do a thing for the loose tissue dangling beneath the chin.

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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