People suffering from chronic distended stomachs should see a gastroenterologist.
By RX FOR READERS/JUDY SIEGEL-ITZKOVICHStomach pain (illustrative)(photo credit: INGIMAGE)I am a 59-year-old man who is usually healthy, but I suffer chronically from gases that cause a distended stomach and pain. My doctor has not found a way to help. What can I do about it?-A.Z.Prof. Ram Dickman, head of the gastromotility unit and Dr. Tzahi Zadok Peretz, a biochemist and head of the gastroenterology lab at the Rabin Medical Center-Beilinson Campus, reply: This phenomenon is very common, and there are numerous causes, but many people have not found relief.Until now, patients have been advised to avoid not only prepared white and other sugars, but also foods containing sugars such as lactose (in milk products) and fructose (in fruit). But this has not been enough.Research into the problem is being conducted around the world. We at Beilinson have discovered that a major cause can be natural bacteria in the digestive system. Recently, it has become known that another factor in stomach gas is small intestine bacterial overgrowth, SIBO. This can result from problems of gastrointestinal motility (movement), inflammatory bowel disease, the repeated use of antibiotics and even drugs against heartburn.In each of these cases, there is significant growth of intestinal bacteria leading to gas, distension, stomachache and diarrhea that interfere with quality of life.This is not a disease, but a situation in which a large number of bacteria grow in the small intestine. In our gastro lab, we carry out tests on patients related to the inability to tolerate lactose, fructose and alcohol sugars, such as sorbitol. In recently completed research we found that SIBO may cause such tests to come out as a false positive, as if the patient is indeed unable to deal with such sugars. This can result in wrong results and improper treatment decisions.We learn from this that people suffering from chronic distended stomachs should see a gastroenterologist, who should test for intolerance to sugars only after checking for SIBO. If this test is positive, the surplus of bacteria in the small intestine can be wiped out with antibiotics.Only then should the other tests be carried out.I would like some information on skin care for a type-1 diabetic. My teenage son uses two devices that are stuck onto his skin. One delivers insulin, and the other monitors his glucose level. The parts of his skin the devices are glued onto gets very sore, and the problem is that he doesn’t have much of a choice as to where to place the devices. As a result, the same area of skin is constantly being affected and doesn’t get a chance to heal properly. It seems I need an ointment that heals skin fast, but I don’t want to use a steroid-based cream. What do you advise? G.S., JerusalemDr. Danny Slodownik, director of the skin allergy clinic at Tel Aviv Sourasky Medical Center, replies: The fact that the skin is closed by occlusion (the blocking of a blood vessel) can cause skin irritation.Most irritations resulting from the use of an insulin pump are nonspecific and caused just by the occlusion.The best way to minimize the irritation is for the doctor who treats him to decide on a small rotation of the location of pump, which will reduce the problem and let the skin heal.In cases in which the irritation is caused by the edge of the sticky tape that holds it in place, one can shorten the tape. If this doesn’t help, his problem is a relatively rare case of an allergy developed to one of the components of the glue, the plastic of the pump or to the metallic needle. This can be diagnosed by conducting special tests in a hospital dermatology clinic.Judy Siegel-Itzkovich notes:In a previous column, we were asked how to prevent a sneeze while driving. The expert said he knew of no such method. But two veteran readers with a lot of life experience suggested ways of preventing sneezes. Ezra Ben-Meir of Nahariya, who is 80 years old, said: “Press the tip of your fingernail on the tip of your nose. It often works for me, but not always.”Ellie Morris, 87, of Mevaseret Zion, suggested another technique that she learned in school. “Our sports teacher was very insistent that we know, just in case we felt a sneeze coming on when about to shoot to score in netball. You rub your tongue along the roof of your mouth until the urge to sneeze passes. It is not 100% successful – but then neither were my shooting attempts!”Rx for Readers welcomes queries from readers about medical problems. Experts will answer those we find most interesting. Write Rx for Readers, The Jerusalem Post, POB 81, Jerusalem 9100002, fax your question to Judy Siegel-Itzkovich at (02) 538-9527, or email it to jsiegel@ jpost.com, giving your initials, age and place of residence.
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