Q: I have kidney stones and was just told that I also have osteoporosis. My doctor also told me that I would have to take Fosamax for at least a year.
Will the Fosamax cause the kidney stones to grow larger as well as replacing the lost bone? I am 70 years old.
-- Name withheld
A: I think it's great that you're asking questions about the possible side effects of a medication. Many drugs have important side effects to guard against, especially when you have more than one medical problem.
With calcium being a key element in osteoporosis and in many kidney stones, it's particularly appropriate to be asking questions. Fortunately, in your case, I don't think it's a problem. Let me explain.
The bony skeleton is remaking itself all the time. The bone formation and reformation is carried out by two types of cells -- one that dissolves bone and one that lays down new bone. When the first type of cells (osteoclasts) dissolves more of the second (osteoblasts), the net result is loss of bone.
This is where Fosamax comes in. This drug acts by slowing down the activity of the osteoclasts, thus decreasing the amount of bone dissolved. As a result, the amount of calcium in the bloodstream and the amount in the urine decreases.
So even if your kidney stones were made of calcium (and many are not), the calcium available to build bigger stones is actually less, not more.
But Fosamax is not totally free of side effects. For example, it's known to increase the risk of problems with the esophagus. Please discuss the side effects with your doctor or pharmacist. And remember that other medications including estrogen and calcitonin can be used if there is a problem.
QUESTION ON CAMPYLOBACTER: What is campylobacter? I had it a few years ago, but I am not sure about the explanation and can find nothing on the Internet. I know that it is some type of food poisoning.
-- B.S., Ft. Lauderdale, Fla.
A: I'm sure you remember your bout with that particular bacterium. It's usually a very unpleasant experience.
Campylobacter is one of a group of bacteria that cause gastroenteritis, an inflammation of the gastrointestinal tract. Like the better-known bacteria, salmonella and shigellosis, campylobacter invades the lining of the intestines and damages the cells there. This causes tiny bleeding ulcerations.
Those ulcerations also allow a considerable loss of body fluid containing proteins and electrolytes. Loss of the electrolytes may be merely an inconvenience for healthy adults, but it can cause severe dehydration for the very ill, the very young or the elderly.
Symptoms include mild to severe diarrhea (which may be bloody), abdominal pain and cramps. Fever that comes and goes may also be present. One type of campylobacter can cause infection in the bloodstream, called bacteremia. This is most likely to occur in people with a weakened immune system.
Campylobacter gastroenteritis is usually self-limited; that is, it will eventually lose steam and go away on its own. However, taking antibiotics can reduce the duration and severity of the symptoms. Antibiotics should definitely be used for bacteremia caused by campylobacter.
In treating any bacterial infection, it is sometimes helpful to know exactly which bacteria is the cause. So stool samples are taken before treatment is begun and cultured -- a sample is spread on a special medium and the bacterium is identified as it grows out.
The infection is usually acquired by drinking contaminated water, eating undercooked meat or coming in contact with infected animals. Travelers in developing countries are much more likely to acquire this infection.
Campylobacter is another reason to be knowledgeable and sensible about what you drink and how you buy, keep and prepare your foods. I hope you suffered no lasting ill effects from your bout with food poisoning and are more careful now.
Dr. Allen Douma welcomes questions from readers. Although he cannot respond to each one individually, he will answer those of general interest in his column. Write to Dr. Douma in care of Tribune Media Services, 435 N. Michigan Ave., Suite 1400, Chicago, Ill. 60611. His e-mail address is DRFamily@aol.com.
This column is for informational and educational purposes only. It is not intended to provide medical advice or take the place of consultation with a doctor or other health-care provider.