Dear Dr. Roach: I am 73 years old, and I consume a glass or two of merlot wine with dinner each day. What, if any, problem exists with sulfites present in this wine?
Dear H.D.: Sulfites are used as preservatives in many foods, including most wines. A dry red wine like merlot has about 50 ppm (parts per million) sulfites, which is about the limit of detection for people with sensitive noses. Some wines can contain as much as 350 ppm. White wines and sweeter wines tend to have higher sulfite concentrations. In contrast, there are foods with much higher sulfite concentrations. For example, certain dried apricots have 1,000 ppm or more of sulfites.
Some people have reactions to sulfites. About 5 percent of people with asthma are sensitive to sulfites. The most common reactions are: skin-related, such as a rash or itchy skin without a rash; gastrointestinal, such as diarrhea and abdominal cramping; and respiratory, including wheezing and cough. A very few people experience anaphylaxis, a life-threatening reaction including collapse of the circulatory system that requires immediate attention.
If you haven’t had any problems with wine, you likely have no reaction to sulfites. If you’ve enjoyed dried fruits without problems, you almost certainly don’t have sulfite sensitivity. If you did have it, you’d need to avoid sulfite-containing foods and look for organically grown wines without added sulfites (some sulfites are naturally present in wine,though they are at a low enough concentration that they may not cause problems). People with severe reactions to sulfites, like anaphylaxis, probably shouldn’t have wine again, but that is a discussion to have individually with your allergist or other doctor.
Dear Dr. Roach: My husband is 80 years old. He was diagnosed with prostate cancer 25 years ago and had radiation treatment. Five years later, he had radiation seed therapy. Five years after that, he started to develop bladder stones, which have to be removed by laser. Then he’s sent home with a Foley bag. This has been an ongoing problem for the past five years, with stones every month or so. The pain is excruciating.
What is the cause of these stones? How can he prevent them? Also, how long should a Foley bag stay in place? So many doctors have so few answers.
Dear T.B.: Stones in the bladder come from the kidney through the ureter. Kidney stones affect 1 in 11 people in the United States, but I couldn’t find any link between the radiation seeds and kidney stone formation. Stones are most commonly treated by laser when in the ureter (the tube that drains the kidney into the bladder). Once in the bladder, they can pass out of the body, unless they are quite large.
With stones recurring as often as he is having them, it is imperative that your husband find out what kind of stones they are so proper medical measures can be taken to prevent their formation. Increasing fluid intake reduces stone formation, but particulars on diet and any medication that might be prescribed depend on the stone analysis, which his urologist can send off.
If your husband has a nephrologist, he or she would be your best bet for getting information specific to your husband. Otherwise, his general doctor should be able to get the stone analysis and make the proper recommendations. Treatment can reduce stone formation by 75 percent.
The Foley catheter should be removed as quickly as is practical, since they predispose a person to infection.
Email questions to ToYourGoodHealth@med.cornell.edu.