August 22, 2006

Cancer, Gout, and Bowel Syndrome

We live in an old mobile home. It’s a 1970 model. Lately I have been hearing a lot about asbestos, which was used freely in years gone by, being harmful to people. How can we tell if there is asbestos in our home? If there is, how do we get rid of it? Could asbestos be the cause of ailments such as lupus and dementia?

Asbestos is an excellent insulation material. However, it has been found to cause mesotheliomas—lung cancers of a specific kind.
There are a couple of types of asbestos fiber—one more irritative than the other. These fibers, when powdered small enough, can be inhaled as dust. They make their way to the pleural surface of the lung, and set up inflammatory reactions, which are forerunners of cancer.

Not everyone who has inhaled asbestos fibers contracts cancer, but sufficient numbers do show it is a real hazard. The fact is that if asbestos is sitting quietly in the wall of your trailer, it will do you no harm. The difficulty would arise when you begin drilling to find it, or start cutting through it.
2006 1524 page14Asbestos is probably best avoided these days; but if it is being removed, it has to be done very carefully, with the people doing the work suitably protected with masks, etc.
As for lupus and dementia—we are unaware of any linkages between these conditions and asbestos exposure, and suggest you do not worry too much about those two conditions.
Rather than poking around the walls of your trailer, you could contact the manufacturer, who would be able to inform you regarding the asbestos content of your home, if any.

I was recently on a trip, and developed a very painful big toe. I saw a doctor, who diagnosed gout. He gave me Tylenol, because I have a history of an ulcer. But I wonder if it really was gout, because I thought gout was a disease of the gluttonous.

Gout does have a reputation of being related to rich foods, but many persons eating a normal diet can also have it. When purines are metabolized, uric acid is a product of their breakdown. Purines are a part of the makeup of DNA molecules, so a diet rich in meats will produce more uric acid. But uric acid levels rise in most people because their kidneys are not clearing it well. Perhaps you are not drinking enough water.
“Gouty” arthritis is caused by crystals of monosodium urate being deposited in the tissues around joints and setting up inflammation. Men are about eight times more likely than women to have gout. Increasing age is another factor. Any problem that diminishes kidney function could bring on gout. Thus, people with hypertension, diabetes, obesity, or even high cholesterol may be at risk. Some medications also raise uric acid levels; these could be low-dose aspirin, or even thiazide diuretics.

The acute phase of gout is best treated with nonsteroidal anti-inflammatory medicine. But your stomach condition probably frightened your doctor. Treatment with a drug called colchicine can help, if given within a few hours of the onset of gout. But colchicine does have side effects.
Some people attempting to prevent acute episodes take allopurinol, which helps block uric acid formation. But allopurinol and probenecid, another medication used to lower uric acid levels, are not tolerated too well by 20 percent of people.
A new medication, febuxostat, has shown greater tolerability and effectiveness in lowering uric acid levels than allopurinol. But long-term side effects of febuxostat are not yet evaluated. Still, if you have gout, keep your ears open. This new medication might help.
In the meantime, drink lots of water to help flush your system, and—if you are a meat-eater—why not go veggie? You will reduce your purine intake that way.

I have a “nervous” stomach, and get cramps and diarrhea easily. The doctor says it is irritable bowel syndrome. Any comments?

For years we have known of the frequent upset of gastrointestinal function if stress gets too high. Before the discovery that peptic ulcer was related to Helicobacter pylori infection, (a specific bacteria that causes an infection in the stomach), it too was thought to be a stress-related disease. Now we know the ulcer caused the stress. With irritable bowel syndrome, the cause is not yet identified with such precision. What is of interest, though, is an increasing awareness of a network of nerves supplying the gut. It is becoming apparent that this gastrointestinal (GI) nervous system may play a large role in communicating between the brain and the gut. Hunger, satiety, toxins in the stomach—all send messages from the GI tract to the brain. This nervous system, more properly called enteric nervous system (ENS), produces chemicals such as serotonin, and may influence mood. In fact, some of the medications used for depression have effects on the GI tract also. This is still an early stage in our understanding of the ENS, but it could be that persons with irritable bowel syndrome will be found to have a problem with the enteric nervous system.

For now, we recommend eliminating highly spiced foods and, by trial and error, picking the other foods you tolerate best.
Of course, if you can reduce the stress in your life by making a special time for Bible reading, meditation, and prayer, you will have benefits that are much greater than a quieting of your “nervous” stomach.

I read recently that a large study, the Women’s Health Initiative, showed that a low-fat diet didn’t make any difference to heart disease and breast cancer. What do you think?

The Women’s Health Initiative study is the first large government study to commence the evaluation of chronic diseases in postmenopausal women. The study has raised several interesting issues, but also—to our mind—questions about its design.
In studying postmenopausal women, unfortunately, the problems under study may already exist and may be irreversible. Additionally, women in the study found it difficult to change their pattern of eating. It’s too bad we are often not interested in health until it’s too late, or we are rigidly fixed in our habits.

The study showed in one area that hormone replacement did not alter outcomes for heart problems. In fact, a few more problems existed in those taking hormones than in those not taking hormones. But these were older women, probably already damaged by atherosclerosis. Animal studies, while showing a protective effect of estrogen, have never shown a curative effect—emphasizing the difference between prevention and cure. For example, monkeys with good arteries were helped to keep them that way by estrogen, but monkeys with atherosclerosis showed no response to the estrogen.
In regard to fat intake, it seems that high or low fat intake is not nearly as important as what type of fat is taken. Again, the study is short—seven years. Can we truly expect a lifetime of incorrect eating to be reversed in seven years?
It is important for our young people to become health conscious. It may be too late once we start having problems in our 60s to make major life-extending differences by lifestyle adjustments.
Allan R. Handysides, M.B., Ch.B., F.R.C.P.(c), F.R.C.S.(c), F.A.C.O.G., is director of the General Conference Health Ministries Department; Peter N. Landless, M.B., B.Ch., M.Med., F.C.P.(SA), F.A.C.C., is ICPA executive director and associate director of Health Ministries.
Send your questions to: Ask the Doctors, Adventist Review, 12501 Old Columbia Pike, Silver Spring, Maryland, 20904. Or you may send your questions via e-mail to [email protected]. While this column is provided as a service to our readers, Drs. Landless and Handysides unfortunately cannot enter into personal and private communication with our readers. We recommend that you consult with your personal physician on all matters of your health.