Dear Dr. Roach: I am 73 years old and consume a glass or two of merlot wine with dinner each day. What, if any, problem exists with sulphites present in this wine?
H.D.
Sulphites are used as preservatives in many foods, including most wines. A dry red wine, such as merlot, typically has about 50 parts per million sulphites, which is about the limit of detection for people with sensitive noses. Some wines can contain as much as 350 ppm. White wines and sweeter wines tend to have higher sulphite concentrations.
In contrast, there are foods with much higher sulphite concentrations. For example, certain dried apricots have 1,000 ppm or more of sulphites.
Some people have reactions to sulphites. About five per cent of people with asthma are sensitive to sulphites. The most common reactions are: skin-related, such as a rash or itchy skin without a rash; gastrointestinal, such as diarrhea and abdominal cramping; and respiratory, including wheezing and cough. A very few people experience anaphylaxis, a life-threatening reaction including the collapse of the circulatory system, which requires immediate attention.
If you haven鈥檛 had any problems with your wine, you likely have no reaction to sulphites. If you have enjoyed dried fruits without problems, you almost certainly don鈥檛 have sulphite sensitivity. If you did have a sulphite sensitivity, you would need to avoid sulphite-containing foods and look for organically grown wines without added sulphites (even though some sulphites are naturally present in wine, they are at a low enough concentration that they may not cause problems).
People with severe reactions to sulphites, such as anaphylaxis, probably shouldn鈥檛 have wine again, but that is a discussion to have individually with your allergist or other doctor.
听
Dear Dr. Roach: My husband is 80 years old. He had prostate cancer diagnosed 25 years ago and had radiation treatment. Five years later, he had radiation seed therapy. Five years after that, he started to develop bladder stones, which have to be removed by laser. Then, he was sent home with a Foley bag. This has been an ongoing problem for the past five years, with stones every month or so. The pain is excruciating.
What is the cause of these stones? How can he prevent them? Also, how long should a Foley bag stay in place? So many doctors have so few answers.
T.B.
Stones in the bladder come from the kidney through the ureter. Kidney stones affect one in 11 people in the United States, but I couldn鈥檛 find any link between the radiation seeds and kidney stone formation. Stones are most commonly treated by laser when in the ureter (the tube that drains the kidney into the bladder). Once in the bladder, they can pass out of the body, unless they are quite large.
With stones recurring as often as he is having them, it is imperative that your husband finds out what kind of stones they are so proper medical measures can be taken to prevent their formation. Increasing fluid intake reduces stone formation, but particulars on diet and any medication that might be prescribed depend on the stone analysis, which his urologist can send off.
If your husband has a nephrologist, he or she would be your best bet for getting information specific to your husband. Otherwise, his general doctor should be able to get the stone analysis and make the proper recommendations. Treatment can reduce stone formation by 75 per cent.
The Foley catheter should be removed as quickly as is practical, since they predispose a person to infection.
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Dear Dr. Roach: I am trying to quit smoking and was recommended a tobacco-free herbal snuff. I have used it once. How do you feel about this?
S.B.
The long-term health risks of tobacco-free herbal snuff are not known. However, it is my opinion that they are likely much less risky than tobacco snuff. I don鈥檛 think it is unreasonable to try tobacco-free herbal snuff as an aid to quitting only 鈥� not as a long-term solution.
Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers can email questions to [email protected].
