Dear Dr. Donohue: Can you give me information on gluten intolerance? What are the symptoms? How is it diagnosed? How often is it the cause of osteoporosis? Will extra calcium help, or does one need to eliminate gluten from the diet? B.B.
Dear B.B.: Gluten intolerance, also known by the names celiac disease or sprue, occurs in about one out of every 250 people in North America.
Gluten is a protein found in wheat, rye and barley. Oats have gluten, but many celiac patients can tolerate oats without suffering symptoms.
Watery diarrhea is a prominent symptom. So is intestinal gas. Weight loss, together with vitamin and mineral deficiencies, is consequent to the loss of food absorption. Gluten poisons the digestive tract.
Symptoms can be so mild that they are dismissed as being within the normal realm. They can also be so pronounced that life centers on the bathroom.
Osteoporosis can appear at a young age due to the defect in absorbing calcium. Taking extra calcium does not help. Restoring normal absorption is the treatment needed.
The diagnosis is made by listening to the patient's symptoms, testing the blood for antibodies induced by the illness, and, most importantly, by a biopsy of the small intestine.
Adopting a gluten-free diet brings about miraculous changes. Gluten-intolerant patients feel like their former selves in short order, and symptoms promptly stop.
The Celiac Disease Foundation can provide people with literature on the disease and keep patients up-to-date on new treatments. Write the foundation at 13251 Ventura Blvd., Suite 1, Studio City, CA 91604-1838.
Dear Dr. Donohue: I was told by a dermatologist that I had a skin disease called dermatophytes. I would like any information you can give me on this. -- L.B.
Dear - L.B.: Dermatophytes (dur-MAT-oh-fights) are fungi that cause infections of the skin, hair and nails. Athlete's foot, for example, is a dermatophyte infection. Ringworm -- tinea -- is another dermatophyte infection.
Most dermatophyte infections can be successfully treated with antifungal creams, lotions, ointments or oral medicines. An exception is dermatophyte nail infection. Annihilating fungal nail infections can be prolonged and expensive.
Write to Paul Donohue, M.D., P.O. Box 536475, Orlando, FL 32853-6475.