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November 4, 2004
Causes of prostatitis
Q: Would you please discuss prostatitis? Could it be caused by something I ate?
A: Prostatitis — inflammation of the prostate gland — comes in four varieties. Although all four have somewhat similar symptoms, they have different treatments.
Common symptoms include an urgent need to empty the bladder, frequent trips to the bathroom, sometimes pain on passing urine, and often nighttime awakenings to urinate.
One variety of prostatitis is acute bacterial prostatitis, a gland infection. This kind of prostate problem inflicts intense pain and often makes a man feverish and forces him to take to his bed. Antibiotics are the treatment.
Chronic bacterial prostatitis is a continuous, smoldering infection of the gland with less intense symptoms than the acute form. Long-term antibiotics are often needed to bring this infection to a close.
Two other sorts of prostatitis are nonbacterial prostatitis and prostadynia. The former is a gland that is inflamed but not due to bacteria. The latter is a painful gland that is not inflamed. Both conditions are difficult to treat. One approach for both is dietary. Abstaining from caffeine, alcohol and hot, spicy foods controls symptoms for many men, although it takes 12 or more weeks to see any results.
Foods and drinks on the prohibited list include coffee, tea, cocoa, cola drinks, chocolate, medicines with caffeine (some forms of Excedrin and Anacin are examples), salsa, curry, horseradish, pepperoni, chilli, hot mustards, ginger, Tabassco, hot sauce, hot peppers and spicy Chinese food. I don’t know how or why this diet works, but it seems to do the trick for a large number of men with nonbacterial prostatitis or prostadynia.
Nothing you ate caused prostatitis. Not eating somethings might cure it.
Q: My mother, 92, has Alzheimer’s disease. She doesn’t recognize me or my brothers and sisters, and she doesn’t know where she is. It has been a terrible ordeal for her, and we wonder how much Ionger she will have to put up with this. Are there any new breakthroughs in Alzheimer’s treatment?
A: From the time they are diagnosed until the time of death, men who have Alzheimer’s live an average of 4.2 years. With women it is 5.7 years.
Those statistics are rough estimates. Some Alzheimer’s patients last 10 or more years, and some die much more rapidly. The severity of mental impairment is a factor that shortens life span.
Another factor that has some predictive value in estimating the time of death is the difficulty a patient has in walking. Frequent falls are also a sign of shortened life expectancy,
There are no miracle breakthroughs in treatment. Namenda, however, is a new medicine that appears to make an appreciable difference in an Alzheimer’s patient’s ability to remember and reason. Sometimes this medicine is used in combination with one of the older Alzheimer’s medications — Aricept, for example.
Q: I am 72-years-old, and I take a multivitamin and calcium. I also take hydrochlorothiazide (Hydro-DILTRIL) for blood pressure. It makes me urinate often.Am I flushing out the vitamins and the calcium with this medicine?
A: You are not flushing out the vitamins or the calcium by taking a diuretic (a water pill). Diuretics are often the first treatment doctors prescribe for blood pressure control. The increased urine production has no effect on the absorption or utilization of vitamins and minerals.
The only mineral that bears watching with your medicine is, potassium. Its blood level can fall because the drug pushes potassium into the urine with the excess water it takes from the body. n
Dr. Donohue regrets that-he is unable to answer individual letters, but he will incomorate them in his column whenever possible. Readers may write to him or request an order form of available health newslettes at PO Box 536475, Orlando, FL 32853-6475
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