DEAR DR. ROACH: I have a rare type of colitis called collagenous colitis. The latest episode was set off two and a half years ago, when I took statins for a short time. I have not been able to get it under control since then. Asacol has not been successful, although it did work in the past. The only thing that seems to work now is budesonide, which is terribly expensive and causes weight gain. Any suggestions? — D.W.
ANSWER: Collagenous colitis causes watery diarrhea, and it can be triggered by certain medications, especially anti-inflammatory drugs, but also statins. Fortunately, it is not life-threatening and doesn't lead to cancer, but the symptoms can be difficult to live with.
Budesonide is considered the most effective treatment. Other options include sulfasalazine (a relative of Asacol) and cholestyramine. Prednisone is much cheaper than budesonide, but doesn't work as well and has even more side effects. Some people with collagenous colitis also have celiac disease, so it might be worthwhile to get tested.
DEAR DR. ROACH: I recently read that drinking beet-root juice helps to increase nitric oxide in the blood. This could increase blood flow in the penis, to help with erectile dysfunction. My question is: How much should one consume to achieve the maximum effect? My weight is 180, and my health is good. — S.K.R.
ANSWER: Beet-root juice, or even a diet high in vegetables, is sufficient to increase levels of nitrate, which can be converted by bacteria to nitrite, which is absorbed into the blood. Blood nitrite then increases nitric oxide, in theory improving blood flow, which could possibly help erectile dysfunction. I could not find a single study confirming that (or even evaluating if) beet-root juice is effective for this indication, even though the theory makes sense. Studies on beet-root juice improving blood flow in athletes shows mixed results — some people are helped; some aren't.