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Ask Dr. Gott 11/07

Bowel gangrene a serious medical condition

DEAR DR. GOTT: You mentioned gangrene of the bowel in your column. I had never heard of this until recently. A friend of mine had a colonoscopy last September and had no problems detected. However, in November, she had a severe pain on a Sunday night, was sent to the emergency room of the hospital and had her colon removed the next day. Gangrene had started to occur. Up to this point, she had never had any bowel problems, so it has been hard to understand why this problem happened so suddenly. My question is, could something have happened during the colonoscopy that she wasn't told about that might have caused this to happen?
    DEAR READER: One of the most serious consequences — fortunately rare — of colonoscopy is bowel perforation. During the procedure, the instrument sometimes pokes a hole in the colon that can lead to serious infection, terminating in gangrene if not treated. Symptoms ordinarily appear in a matter of hours but may be masked for several days. A two-month wait would be virtually impossible. Therefore, I doubt that the colonoscopy caused the gangrene your friend experienced.
    Bowel gangrene is more often the consequence of colon ischemia, arterial blockage of colonic segments leading to death of intestinal tissue. In the elderly, sudden or recurring abdominal discomfort must include bowel gangrene as a possible cause. For this reason, emergency scanning studies are necessary for diagnosis and to define the extent of the problem before surgery, the only life-saving cure.
    Abdominal pain in children is commonly caused by appendicitis. However, in adults, there are many other causes, ranging from gallbladder disease and peptic ulcer to bowel ischemia and cancer.
    I believe that your friend had appropriate treatment for her colonic problem, which was not related to her colon study two months before.

    DEAR DR. GOTT: I am in serious need of your help! I am a 24-year-old female and I am having trouble with my right ear. Every time there is a moderately loud noise, my ear starts buzzing. The buzzing is getting worse each day, and now, whenever I laugh or even talk loudly, I have to plug my ear. Even the water hitting my cheek in the shower makes it buzz. I have seen two ear specialists and have had several hearing tests only to reveal that I have perfect hearing. One doctor told me it could possibly be a tumor but not likely. The buzzing seems to be getting worse and more frequent, and I am worried about permanent damage. Any suggestions?
    DEAR READER: You are suffering from an unusual form of tinnitus (ear noise).
    I recommend that you be examined by another ear-nose-and-throat specialist to discover the cause of your tinnitus. Additional opinions in situations such as these are generally extremely valuable.
    To give you related information, I am sending you a copy of my Health Report "Ear Infections and Disorders."

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