Last Updated: March 11. 2011 1:00AM Dr. Paul Donohue: your Health

Dear Dr. Donohue: I had prostate cancer two years ago and went through 42 radiation treatments. The result of this is colon and rectum damage. I passed lots of blood, and still do. I am told there isn’t much treatment to help this problem.

What is your opinion? Is there any medicine that could help?

P.S.

Dear P.S.: your complication of radiation therapy is called radiation proctitis (prock-TIE-tiss). Only a thin layer of tissue separates the rectum from the prostate gland. some radiation is bound to pass into the rectum and damage the rectal lining. That causes pain and bleeding. It appears within six weeks of treatment and lasts for a year or so.

However, chronic radiation proctitis appears nine to 14 months after treatment. The lining of the rectum is quite severely injured, and the rectum is scarred. some blood vessels are lost. others become fragile and bleed. Diarrhea, rectal pain, loss of rectal control, bleeding and bowel obstruction are some of the possible complications.

If stool has become hard and difficult to evacuate, stool softeners are helpful. if the rectum has become so narrow that stool cannot exit, a doctor can dilate the rectum with balloons. Rectal enemas containing prednisolone (a cortisone drug) along with oral sulfasalazine often bring some relief. Hyperbaric oxygen has been used. however, the equipment needed to administer oxygen under pressure isn’t widely available. Surgery might be needed for symptoms that are not improving.

The doctor who was in charge of your treatment ought to know what is available in your area.

Dear Dr. Donohue: I was surprised to find a topic in your column that relates to the work I do.

A reader, identified as A.S., shared that she had been diagnosed with pulmonary hypertension and was having problems obtaining the medication her doctor had prescribed. The problem was that out-of-pocket costs were too expensive for her.

I work for a charitable organization that provides financial assistance to people in her situation, and her illness is one of the diseases we support. Our address is: Caring Voice Coalition, 8249 Meadowbridge Road, Mechanicsville, VA 23116, 888-267-1440, caringvoice.org.

D.H.

Dear D.H.: Thank you for your letter. I was unaware of your organization. I will mention it as many times as I can. Illnesses covered by Caring Voice are alpha-1 antitrypsin deficiency, chronic granulomatous disorder, complex partial seizures, Huntington’s disease, idiopathic pulmonary fibrosis, infantile spasms and pulmonary arterial hypertension.

Dear Dr. Donohue: my son is due for surgery on an umbilical hernia. I am worried. I’d like to know more about it, including recovery time. he lives on the West Coast, and I live on the East Coast.

Dear A.D.: all hernias are a protrusion of abdominal tissues or abdominal organs through a defect in the abdominal wall. The abdominal wall includes muscles and ligaments. Umbilical (bellybutton) hernias are common in infants. They often correct themselves. Umbilical hernias that develop in adulthood require surgery if they are large or painful. The operation should not take your son off his feet for any length of time. unless he does heavy physical labor, he might be back to work in two or three weeks.

Write to Dr. Paul Donohue at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from rbmamall.com.

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Last Updated: August 12. 2010 1:00AM Dr. Paul Donohue: Your Health

Dear Dr. Donohue: Do your readers a favor by telling them about Cushing’s syndrome. it took six years before I was diagnosed. the delay cost me my job and my fiance. I gained weight and had stretch marks all over. Doctors told me to lose weight by dieting and exercise. I did both, but continued to gain weight. Then my blood pressure rose. Finally, a doctor, to whom I owe my life, came up with the correct diagnosis. I had an operation, and my life has changed for the better.

P.A.

Dear P.A.: Cushing’s syndrome is an overproduction of cortisone. our adrenal glands, sitting above the kidneys, turn out this hormone, which is essential to life.

At first, an overproduction of cortisone produces signs and symptoms that are quite subtle and go unrecognized. As time goes by, weight is gained, the face becomes round and red, the arms and legs remain thin, the chest and abdomen expand. the skin thins and is easily injured. Purple stretch marks appear. Menstrual irregularities occur. Women sprout facial hair. Muscles weaken, as do bones (osteoporosis). Blood sugar rises, and so does blood pressure. all of this comes from having too much cortisone.

The trouble can lie in either of two places, the pituitary gland on the underside of the brain, or the adrenal glands (above the kidneys) that make the hormone. the pituitary gland produces a hormone that stimulates adrenal-gland production of cortisone. Tumors of the adrenal gland, independent of the pituitary gland, can rev up their production of cortisone on their own.

It’s treated by turning off cortisone production. Surgery is the answer to both causes of Cushing’s. With the pituitary gland, the approach can be through the nose or roof of the mouth to reach the pituitary gland and destroy the tumor. When the adrenal gland is the cause, surgery is more involved.

Dear Dr. Donohue: my artificial sweetener has a warning saying it contains phenylalanine. why? is it a dangerous material?

K.S.

Dear K.S.: Phenylalanine is an amino acid, one of the bricks from which the body builds proteins. it is not a dangerous material. However, a few individuals are born without the ability to metabolize this amino acid. Discovery soon after birth is important so that phenylalanine can be eliminated or severely limited in these babies’ diets.

Write to Dr. Donohue at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from rbmamall.com.