Q. I have been diagnosed with pruritus ani, itching around the anal area. This condition causes itching so intense that it can keep me up at night.
My doctor ruled out hemorrhoids and other causes. I was told to stay away from cortisone creams, as they could make the condition worse. Is there any natural remedy that can help this intense itching?
A. You may want to start with a bidet. Gentle cleaning of the posterior with a stream of warm water may be less irritating and better than using toilet paper.
Most people associate bidets with the French, but the Japanese have perfected toilet technology. Not only do their toilets wash the bottom, but some dry it with warm air. The price can range from a few hundred dollars for a seat installed on your existing toilet to thousands of dollars for a stand-alone luxury unit.
Readers who have traveled abroad appreciate bidetlike features in a toilet: "After suffering with hemorrhoids or itching most of my life, I found the solution on a trip to Thailand in the form of the bathroom bidet sprayers they use there. This device is the ultimate in logical simplicity; it allows you to clean without rubbing or soaps that irritate the skin and perpetuate the itching."
Another option is to clean with witch-hazel-dampened toilet paper. Witch hazel is a natural astringent and eases irritation.
Q. I am 55 and was diagnosed with osteoporosis last April. I just learned that I am deficient in vitamin D.
I have felt fatigued and mentally foggy as long as I can remember. Could I have been vitamin D deficient for years and, as a result, developed osteoporosis?
I have read about the dangers of drugs like alendronate (Fosamax) and would like to learn about other ways to deal with osteoporosis.
A. Vitamin D deficiency can contribute to many chronic problems, including weakened bones and cognitive difficulties (CNS Drugs, August 2011). Ask your doctor to check you for celiac disease, since this condition can lead to multiple nutritional deficiencies, osteoporosis, fatigue and dementia.
Many prescription drugs are used to treat osteoporosis. Some, such as Actonel or Boniva, are similar to Fosamax and can also cause bone, joint or muscle pain, heartburn and eye inflammation.
Other options, such as low-dose estrogen (Menostar), raloxifene (Evista), calcitonin and teriparatide (Forteo), along with nondrug approaches, are described in the Guides to Osteoporosis and Vitamin D Deficiency that we are sending you.
Anyone who would like copies, please send $5 in check or money order with a long (No. 10), stamped (65 cents), self-addressed envelope to:
Graedons' People's Pharmacy
No. DU-29, P.O. Box 52027
Durham, N.C. 27717-2027
Each guide also can be downloaded for $2 at peoplespharmacy.com.
Q. I have had COPD for decades. After taking azithromycin for about 15 weeks, I am feeling well for the first time in more than 20 years.
A. A placebo-controlled study found that the antibiotic azithromycin can reduce flare-ups associated with chronic obstructive pulmonary disease (COPD), an inflammatory condition that makes it difficult to breathe (New England Journal of Medicine, Aug. 25, 2011). The downsides of long-term azithromycin include hearing loss, digestive distress, rash, itching, dizziness and serious allergic reactions.