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CURING RETENTION OF BODY FLUID IN ABDOMEN DEPENDS ON CAUSE

Dear Dr. Donohue: Could you please explain ascites, the abdomen swelling problem? Is it curable?

- B.G.

Answer: Ascites (uh-SIGH-teez) arises from retention of body fluid in the abdominal cavity. Its earliest sign is a sudden need to let out the belt many notches. Eventually, the person has breathing difficulty because of the inability to lower the diaphragm sufficiently to draw a full breath.

Besides the obvious patient discomfort from the swelling, ascites can be a sign of major illness. Cirrhosis of the liver is a possibility, as is congestive heart failure. Some cancers produce ascites.

The curability of ascites depends on the control of the cause. Treatment thus can take many avenues. In general, however, discouraging fluid through salt restriction becomes a basic part of ascites control.

Bed rest also helps achieve a certain abdominal drainage, the kidneys are able to work more efficiently while the patient is lying on his back.

Spironolactone and other types of water pills are used to reduce ascites swelling.

Dear Dr. Donohue: The terms "ASHD," "hyponatremia" and "chronic brain syndrome" were on my mother's death certificate. The immediate cause was listed as "congestive heart failure and myocardial infarction." I wonder if all this is a reference to a mental condition. Mother was often depressed. I would like to translate all the above.

- D.W.

Answer: Alien words and confusing acronyms are parts of most death certificates.

"ASHD" stands for "arteriosclerotic heart disease," which means heart disease brought on by blockage of heart arteries. You can find those letters on many death certificates. You might find ASHD listed as "CAD," for "coronary artery disease" - same thing.

ASHD leads to a heart attack - technically myocardial infarction, literally "heart muscle death."

Congestive heart failure is a weakening of the heart, an inability of the heart muscle to pump sufficient blood.

Hyponatremia is a low body sodium level, which goes along with fluid retention, both frequent companions of congestive heart failure.

Chronic brain syndrome might have something to do with mental problems. The syndrome is evidence of certain changes occurring in the brain, often from a series of events such as multiple mini-strokes.

Was your mother's depression part of her death? I cannot say, and perhaps no one else can at this point. It's likely that it was.

My condolences. The "Understanding Your Heart" pamphlet that I'm sending you contains more information. Others can order the pamphlet by writing: Dr. Donohue - No. 31-4, Box 5539, Riverton, NJ 08077-5539. Enclose $3 and a self-addressed, stamped (55 cents) No. 10 envelope.

Dear Dr. Donohue: What causes keratosis pilaris, and what does it amount to? What treatment is available to get rid of it?

- M.A.B.

Answer: Keratin is a protein substance that makes up certain body tissue, such as skin, nails and - in the case of keratosis pilaris - hair follicles.

Keratosis pilaris can give skin a goose-bump appearance. Most common sites for keratosis pilaris are the upper arms, thighs and the buttocks. The cause is not understood.

Two often-recommended treatments are tretinoin ointment and a lactic acid lotion.