Archive for June, 2012

What is an anal fissure?

DEAR DOCTOR K: I've had pain and some bleeding during bowel movements. My doctor says it's an anal fissure. What is that, and what's the best way to treat it?

DEAR READER: An anal fissure is a rip in the lining of the anal canal. It usually results from trauma, such as passing hard stool. It causes severe pain, often accompanied by a small amount of blood. Pain from anal fissures often is confused with pain from hemorrhoids.

How does stress affect cardiovascular health?

DEAR DOCTOR K: I'm under a lot of stress at work. My doctor warned me that if I don't get my stress under control, it could affect my cardiovascular health. Is this true?

DEAR READER: Yes, it's true. Long-term, constant stress can harm many aspects of your health, including your cardiovascular health. Stress is the body's way of responding to threat. Our distant prehistoric ancestors had a pretty stressful life, but it was different than the stressful lives we have. They knew that at any moment they might be killed. Back then, it was lions that were the threat.

How can I control my chronic bronchitis?

DEAR DOCTOR K: After years of smoking I've developed chronic bronchitis. Every morning I cough up lots of mucus. What can I do to control this cough?

DEAR READER: Chronic bronchitis is a common form of chronic obstructive pulmonary disease, or COPD. COPD refers to a group of disorders that damage the lungs and make breathing increasingly difficult over time. Most cases of COPD are related to cigarette smoking.

How does aging affect vision?

DEAR DOCTOR K: What changes can I expect to my eyes and vision as I get older?

DEAR READER: In most of us, nearly every part of our eyes shows changes caused by aging. As eyes age, eyelid muscles weaken and skin becomes thinner and looser. This can cause the upper lid to droop or the lower lid to sag. Tear production also drops off, and the oily film that tears provide decreases. These changes can lead to a buildup of sticky mucus, or they can dry the cornea, causing irritation or an uncomfortable, gritty sensation.

How can I treat jock itch?

DEAR DOCTOR K: I have terrible jock itch. Please tell me how to get rid of it!

DEAR READER: I understand your urgency. Jock itch is uncomfortable, and scratching where this rash usually appears — the inner thighs and groin — isn't something you want to do in public. The term "jock itch" refers to an itchy rash caused by a common skin fungus known as tinea cruris. Most often, jock itch develops when tight garments trap moisture and heat. This creates an environment in which fungi multiply and flourish.

Should I take fish oil supplements?

DEAR DOCTOR K: I've heard that fish contains oils that are good for your health. Does this mean I should take a fish oil supplement?

DEAR READER: You heard right. A good deal of evidence suggests that fish oils are good for your health. I wish I could say, "So just eat fish and take fish oil capsules, and your health will be great." But of course it's not that simple.

Can dietary changes help with interstitial cystitis?

DEAR DOCTOR K: I have interstitial cystitis. Medication hasn't helped much. Could dietary changes help?

DEAR READER: In patients with interstitial cystitis (IC), the bladder wall becomes irritated or inflamed, causing pain and painful or frequent urination. Some patients need to urinate as often as 60 times a day. The cause of IC remains a mystery. The symptoms of IC are often similar to those of a bacterial urinary tract infection. However, in IC, there is no bacterial infection and the symptoms do not respond to antibiotics.

A second look at the pain of colposcopy

In a recent column, I described a procedure called colposcopy, in which a woman's cervix is examined and, if necessary, biopsied to look for evidence of cancer. I described the procedure as "generally safe and painless ... but you may experience some mild cramping or a little discomfort." A few readers wrote me to strongly disagree with my wording. One said that the vinegar wash burned. All said a biopsy of the cervix was painful. Needless to say, I have not myself experienced a colposcopy. So I asked three gynecology colleagues here at Harvard about their experience.

Why am I developing dark patches of skin on my face?

DEAR DOCTOR K: I'm a woman in my late 20s, and I've developed dark patches of skin on my face. Why did this happen? What can I do about it?

DEAR READER: It sounds like you could have melasma. This is a condition in which areas of skin become darker than the surrounding skin, typically on the face. The number of pigmented skin cells called melanocytes is higher in the darker areas of the skin. Why there are increased numbers of melanocytes in certain places and not others remains a mystery.

What can I do about plantar warts on my feet?

DEAR DOCTOR K: I have warts on the bottoms of my feet. How can I get rid of them?

DEAR READER: The warts on the soles of your feet are called plantar warts. They are essentially the same as other warts except that they are hard and flat. I've had them, and boy, are they aggravating. Warts are highly contagious, so they're easy to pick up, especially if you walk barefoot on moist, warm or dirty surfaces.