DEAR DR. DONOHUE: For more than two years I suffered with stomach pain and loose bowel movements. The pain and diarrhea weren’t there all the time, but they were there enough of the time that they made life miserable. My doctor says I have irritable bowel syndrome and to live with it. How do I go about doing that? – F.Z.
ANSWER: Irritable bowel syndrome is the No. 1 stomach complaint that brings people to the doctor. The pain is usually described as crampy, and it can occur anywhere in the stomach – top, bottom, right side or left. Along with stomach pain, a second, always-present symptom is a change in bowel habits. People can have diarrhea, constipation, or diarrhea alternating with constipation. Bloating, belching and gassiness are other common symptoms.
The exact nature of this malady is uncertain. However, it has been proposed that the muscles of the intestinal wall contract haphazardly. Rather than moving food along in a synchronized wave of muscle action, the wall muscles are out of step, and the result is intestinal chaos and pain.
The results of all lab tests, X-rays, scans and scope exams are normal. Such tests often must be done in order to be positive that there are not other processes responsible for the symptoms – such things as ulcers, diverticulitis, ulcerative colitis and even the biggest of all scares, cancer.
Psyllium is fiber, and it’s on drugstore shelves under many brand names. It sounds like a poor treatment choice for irritable bowel syndrome, especially for those with diarrhea. But it actually is a good choice. It holds liquid in undigested food, so it helps move fecal material through the tract without straining. It also prevents excess liquid from staying in food residue, so it can help control diarrhea. Dicyclomine (Bentyl is one brand name) might calm digestive wall muscles and lessen pain. And the antidepressant drug imipramine slows the passage of food through the tract and can blunt pain signals arising in it.
DEAR DR. DONOHUE: What is rose fungus? My neighbor, an avid gardener, is laid up with this. Could I get it from her? How common is it? I am a gardener too. – C.B.
ANSWER: You must be talking about the fungal infection sporotrichosis (SPORE-oh-try-COE-suss). The fungus clings to many plants and is found in organic material such as sphagnum moss. Because roses have thorns that stick gardeners, roses are better at inoculating this fungus into people than thornless flowers and plants.
Once the fungus gains entry into the skin, it forms a small red bump. In the ensuing weeks, a line of red bumps appears on the arm (assuming that the hand or arm is the site of initial infection) as the fungus moves upward. The bumps often ooze pus, and sometimes they form open sores.
There are effective medicines for it. Itraconazole is one.
You won’t catch this from your neighbor.
Considering the large army of gardeners and rose lovers, it is safe to say sporotrichosis is an uncommon infection.
DEAR DR. DONOHUE: My 2-month-old son has a testicle that has not come down into his scrotum (the left one). Our pediatrician says we don’t need to do anything right now because it might still come down. I am uneasy about this. Is it safe to wait, or should something be done right away? – W.M.
ANSWER: During fetal development, the testicles are located within the abdomen. In the weeks before delivery, they migrate down into the scrotum.
About 4.5 percent of infant boys have one undescended testicle. By six months, only 0.8 percent still have an undescended testicle. Waiting, therefore, makes a lot of sense.
If the testicle doesn’t descend, then the condition can be surgically corrected between the 9th and 15th months. Leaving a testicle in the abdomen can foster cancer changes later in life.
DEAR DR. DONOHUE: I am a 76-year-old woman and have had annual Pap smears for the past 25 years. Nothing was ever found on them. Can I stop having these smears done? The examination has always been painful for me. – B.D.
ANSWER: Different advisory groups have different guidelines on the age at which a woman can safely stop having Pap smears.
One group says that a woman can stop having the test done at age 65 if her previous three tests have been normal and if no suspicious findings were seen in the prior 10 years. The chances that such a woman would ever have cervical cancer are remote.
A different group abides by the above but uses the age of 69 as the time when no more testing need be done.
A third expert panel sets the age for stopping at 75.
You are at an age when even the most stringent guidelines would let you stop the test. Talk with your doctor. He or she might have a good reason for wanting the test continued.
Readers who would like more information on Pap smears and cervical cancer can order the pamphlet on those topics by writing: Dr. Donohue – No. 1102, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.50 U.S./$6.50 Can. with the recipient’s printed name and address. Please allow four weeks for delivery.
DEAR DR. DONOHUE: I’ve been told that penicillin doesn’t work anymore. Now we are given expensive pills that take forever to work. In the past, a shot of penicillin would clear me up in three days. I wish you would tell me why this has happened. – M.K.
ANSWER: Penicillin was and still is a miracle drug. It does not work for all infections. It never did. And it has lost its ability to cure some infections that it was able to eradicate with ease. The reason for that is it has been used for illnesses that it should not be used for - viral infections are a case in point. That has caused the rise of resistant bacteria. Don’t pressure your doctor to give you antibiotics if the doctor does not feel you have a bacterial infection.
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.
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