DEAR DR. ROACH: I have read that whether stools float or sink could be an indication of one’s health, even to the point of being an early sign of pancreatic cancer. Isn’t it just about density and gas — that is, doesn’t most food we eat float in water, and if you mix in gas, shouldn’t most stools float? I used to have a lot of sinkers, but now I eat a lot less meat and more fish, fiber and salads. I also take a lot of supplements, so perhaps those are not getting completely absorbed and hence, creating more gas in the stools? For the past two years, I have floaters 80 percent of the time, but my doctor does not seem concerned. Should I be alarmed or see a specialist? — A.A.

ANSWER: We ask about stools floating because it can be a sign of poor fat absorption. Several conditions can cause this, including celiac sprue, inflammatory bowel disease, infection and pancreatic insufficiency. These conditions usually have other symptoms, so floating stools by themselves are not a cause for alarm.

Diet is indeed the likely cause.

DEAR DR. ROACH: I am writing in regard to your column on pancreatitis. My sister went to hospital with the same symptoms and was diagnosed with pancreatitis as well. The doctor implied that she must be an alcoholic because her liver enzymes were elevated. I had had my gallbladder removed several years earlier because it was non-functioning (our family history includes gallstones). This was determined by a test in nuclear medicine. When I reminded my sister, she requested this test and her gallbladder also was not functioning. They removed the gallbladder, and she has not had an attack since (this was 10 years ago). She also was diagnosed with hemochromatosis, which was the reason for the changes to the liver. I hope this information will benefit other people suffering from pancreatitis. — S.P.

ANSWER: Thank you for your note. Several people have written that pancreatitis is too often assumed to be due to alcohol abuse. Gallstones are the other common cause, and usually are diagnosed with an ultrasound. However, it sounds like you had acalculous cholecystitis (a serious gallbladder inflammation without stones), and you probably had a HIDA scan, which is sometimes needed to make the diagnosis. Pancreatitis is less common with acalculous cholecystitis, and may represent gangrene of the gallbladder, a surgical emergency.

I assume you have been tested for hemochromatosis? It also runs in families.

DEAR DR. ROACH: In your column, I read that for vaginal atrophy (dryness/itching) you suggest that a woman use topical cream instead of estrogen cream. I am 59 years old, and have been using Premarin cream externally for a month with noticeable results. I use a dab every other day. Should I continue to use it even when I don’t have symptoms, or only as needed? If you think non-hormonal cream would be better, could you suggest one? I have tried one, but it didn’t seem to be effective. — A.A.

ANSWER: I’m sorry I wasn’t clear. “Topical” in this case meant a vaginal estrogen cream, as opposed to estrogen taken by mouth. I would continue using it, since it has been effective. Most women use it twice a week after initial treatment.

Non-estrogen creams are fine for many women, but estrogen creams like Premarin usually are more effective.

Dryness and itching may be caused by recurring vaginal infections, which are often troubling to women. The booklet on that topic explains them and their treatment. Readers can order a copy by writing: Dr. Roach — No. 1203, 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.

Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Health newsletters may be ordered from www.rbmamall.com.

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