Question: Please discuss the spleen. What causes it to become enlarged? What is the treatment for it?
- R.C.Answer: The spleen measures about 5 inches across. Lying just beneath the lower rib cage on the left side, next to the stomach, the spleen performs dual roles - as a filtration system for worn-out red blood cells and germs and assembly point for germ-fighting antibodies. We seldom hear from the spleen in its normal condition.
Enlargement is a familiar spleen symptom, with a catalog of conditions leading to it. A familiar cause is mononucleosis, which brings temporary enlargement. Cirrhosis of the liver, on the other hand, causes a permanent spleen enlargement. Because of its rich blood supply, the spleen in an enlarged state poses a threat of rupture and hemorrhage. For that reason, mono patients, for example, are instructed to avoid heavy physical contact until the spleen has reverted to a more normal size.
Generally, the treatment for an enlarged spleen depends on what is causing the enlargement. In certain anemias, where the spleen is part of the problem, the organ might be removed.
Question: Can you give me a brief rundown on psoriasis, including
treatment? - L.P.
Answer: In a word, psoriasis occurs because the person's skin cells mature too rapidly. Normally, skin cells gain adult status about a month after beginning their outward migration from the inner skin surface. With psoriasis, those same skin cells make that journey in a few days. The characteristic silvery scales and reddening of psoriatic skin result.
Dermatologists have studied the problem since the early days of medicine, and the search for a definitive cure goes on. For the present, many treatments are available - some old, some new; some useful, some not so useful. They include cortisone creams, coal tar preparations, ultraviolet light exposure, drugs such as cyclosporine and methotrexate and skin preparations of a vitamin D-like substance. A call to the National Psoriasis Foundation - (800) 248-0886 - for a free packet of information would bring you abreast of new
developments.
Question: When should vitamin supplements be taken, before or after meals? And should they be taken with or without liquids, or with water, milk, fruit juice or whatever? This has been an ongoing argument with my spouse for many years now.
- R.C.
Answer: You are not the first to ask the question. But I've never had a decent answer to it. In search of an answer, I recently scoured the journals, the drug books and the research services - to no avail. Labels on vitamin containers yield no satisfaction either. Meanwhile, I had a call in to a reliable manufacturer of a multivitamin product containing both the water-soluble and the fat-soluble kinds. I was assured that a person could take that vitamin product before or after meals and with most fluids - milk, water, fruit juice, etc. It doesn't matter.
Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him at P.O. Box 5539, Riverton, NJ 08077-5539.