Dear Dr. Roach: I am a 63-year-old woman who has always carried extra weight, but I have gained a few more pounds in the past year. I am overweight but not obese. I have been having a problem with my navel, and have been told that it is a yeast infection. I was given medication and was told to use it every day ... forever. Is there no way to decrease the amount of yeast a body produces? I also get it under my breasts (when it gets hot and humid in summer) and anytime I take an antibiotic. — P.R.

Answer: Your body doesn't produce yeast, any more than it produces the bacteria that normally live on your skin. However, some people are more likely to have excess growth of the yeast that is present in many people. Yeast like to grow where it is warm and moist, so anyplace the skin folds (the axilla, groin, abdominal folds and under the breasts) is a common place for yeast to grow, causing discoloration and itching. This goes by the medical name of intertrigo.

Bacteria and yeast live together, so when an antibiotic kills bacteria, yeast often increases, both on the skin and in the mouth (thrush) or vagina ("yeast infection"). There are medical conditions that can increase this risk, especially diabetes, but also conditions that depress the immune system, such as treatment with chemotherapy or an HIV infection. I recommend being tested for diabetes if you have recurrent yeast infections.

Rather than taking medication forever, there are ways to reduce yeast growth. Keep the skin dry by wearing appropriate clothing and using antiperspirants (which can indeed be applied under the breasts) or powder, such as cornstarch. This may solve the problem. (Although there are conflicting reports about aluminum-based antiperspirants and breast cancer, the National Cancer Institute and the U.S. Food and Drug Administration have said there is no conclusive evidence of this. On the other hand, using talcum powder in the groin has been associated with an increased risk of ovarian cancer.) Losing weight also may help, though I realize that is about the most difficult thing we doctors ask people to do.

Many people feel that a diet low in sugar and processed grains, and made with yeast helps the rash. Studies have not confirmed this, but I believe in a low-sugar, low-processed-grain diet in any event.

Dear Dr. Roach: I am a 75-year-old male. I have had hemorrhoids for many years, with no pain and little discomfort. I have declined to have hemorrhoid surgery over the years. I have been taking multivitamins and several supplements — currently coQ-10, glucosamine and chondroitin/MSM, calcium and fish oil — for many years.

I sometimes have days or so of bleeding bowel movements, which I have attributed mostly to taking or missing my vitamins and supplements irregularly for a day or so, and it ceases when I get back on track. I have had regular colonoscopies with, at worst, polyps found and removed, saw a gastroenterologist for a while, sometimes used creams and suppositories, and have otherwise discussed it with my primary and other doctors over the years. My stool has mostly been on the firm side.

Do you know of vitamins or supplements, or lack thereof, causing my occasional bleeding bowel movements? — B.L.

Answer: I suspect that without the fish oil, you would have some constipation, which would tend to exacerbate the symptoms of hemorrhoids. Fish oil causes diarrhea in some people, and it makes sense that it might relieve hard stools.

Certainly I wouldn't consider surgery with as minimal symptoms as you are having. Since your periodic colonoscopies are fine, I'm not really worried about any hidden cause of bleeding.


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