Dear Dr. Donohue: I've suffered from ulcerative colitis since I was 16. I am now 21. My mother passed away two years before my diagnosis from complications of the same disease. No medicines helped her. I've taken a laundry list of medications. They work for about three weeks at most.
I can have up to 20 bowel movements a day, occasionally with blood in them. My doctor says the only other medicine that has a chance of working is Remicade. I researched it, and found that most people only get relief for up to a year, and it has side effects such as cancer and death. I have stopped all medicines for a year and a half, with slight improvement. My stools are still loose, but have dropped down to seven to 10 times a day. Can you give me info on new methods to combat this disease?
P.
With ulcerative colitis, the colon is studded with ulcers (sores).
Diarrhea, abdominal pain and weight loss are the manifestation of this illness. Often, it runs in families.
The initial medicines for ulcerative colitis are sulfasalazine, Pentasa and Asacol. If they don't calm the inflamed colon, prednisone is the next step. Cyclosporine is given intravenously when the illness is unresponsive.
Remicade (infliximab) is a newer medicine that soothes the colon by neutralizing a body-made substance called TNF (tumour necrosis factor), a material that promotes inflammation and ulcer formation. It's also used for Crohn's disease (another inflamrheumatoid arthritis. Many of these patients, including those with ulcerative colitis, have enjoyed a long remission from their illness. Another newer medicine for ulcerative colitis is Humira (adalimumab). It has shown promise for control, should Remicade not work.
Remicade does have serious side effects. Deaths are truly infrequent, infinitely less than automobile deaths. Lymphoma, a cancer of the lymph nodes, has appeared in some users, but the incidence is small.
Dear Dr. Donohue: I contracted restless leg syndrome. It affects me mainly at night. I take one and a half tablets of pramipexole to allow me to get to sleep. The side effects, however - tiredness, for one - last well into the next day.
Will RLS be with me for the rest of my life? I am 87.
P.D.
Restless leg syndrome is a jitteriness and often painfulness that arises in the legs when a person sits or, more often, when lies down in bed. The sensations drive a person to get up and move about for relief. Have you tried nonmedicine treatments, like a warm bath before bed along with massage of the legs? You might be able to cut back on the dose of your medicine.
People have told me that their restless legs have become normal in time. Others have told me differently - their restless legs have stayed with them unless they used medicines on a constant basis. The course of this disorder is unpredictable.
Dear Dr. Donohue: Please say something about the treatment for hydroceles. Will wearing a jockstrap supporter help?
G.G.
A hydrocele is a collection of fluid in a sac within the scrotum. Permanent correction involves surgically removing the sac. A jock strap won't be helpful. If the fluid collection is small and not bothering you, it can be left alone. You should, however, show it to your doctor.
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