QUESTION: Just what causes ulcerative colitis, and is 41 young for a woman to develop this illness? My oldest sister has been informed this is her problem. She asked me if diet might be a cause. Can it? Please discuss. - Mrs. J.L.

ANSWER: Ulcerative colitis is inflammation of the colon that has caused formation of ulcerated sections. The chief symptoms are cramping pain and diarrhea, most often of the bloody or mucous type.There are about 2 million Americans who have this problem, and 41 is not young to develop it. Most patients, in fact, are between the ages of 20 and 40. However, if one is prone to it, it can occur at any age. About 15 percent of those with it developed it prior to age 16.

All of this makes us wonder about cause. Some feel the initial inflammation may reflect an autoimmune factor, that is, the attack of one's own tissue by the body's protective mechanisms. Others feel it represents a viral infection. The problem lies in recognizing ulcerative colitis early enough so that effective treatment can be started in time. This can avoid many of the complications from chronic colon inflammation.

Many drug treatments are available, beginning with cortisone drugs to stop the inflammation. After inflammation is brought under control, there are drugs to ease mild attacks. For stubborn attacks that resist normal medications, we now are looking into drugs to suppress the immune system. In a small number of cases, surgery becomes the last resort.

As to diet, there is no specific one. Some patients find that certain foods, like dairy products, cause flare-ups. Good nutrition, given the diarrheal aspects of the problem, is important to keep in mind always.

QUESTION: Can you tell me what shock is? My first pregnancy was an ectopic one, at which time a fallopian tube burst. Though I had no pain, I lost much blood and was in grave danger. The doctor said I was "in shock." - A.R.

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ANSWER: Shock is failure of the circulatory system. When that happens blood pressure plummets, the skin becomes clammy and cold, and urine production ceases. Yes, this is a grave situation.

One cause of shock is blood loss from a hemorrhage. Blood pressure drops because there is little blood to pump. That is the kind of shock you had. Another cause of shock is heart attack. Here, the heart becomes so weak that it cannot pump blood. Blood pressure drops and shock ensues.

There's a third and completely different kind of shock that comes from certain kinds of serious infections. In such infections, the bacteria release poisons that lead to a profound drop in blood pressure. That's called septic shock. An example of this might be toxic shock syndrome. In that, bacteria growth encouraged by use of certain types of tampons released poison (toxin) into the bloodstream of the victim, causing septic shock symptoms.

C) 1989 North America Syndicate Inc.

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