Dr. John: Shingles, ticks, Celiac Disease

KUSA - Dr. John Torres from Premier Urgent Care answers your questions every week. If you have a medical question for Dr. John, send it to mornings@9news.com and make sure to have Ask Dr. John in the subject line.

Question #1
I am a retired male in very good health. I have had my flu & shingles shot. My curious question is = Can a person have the shingle virus and won't show up on the skin surface. Seniors talk about many things. P.S. Curiosity may have killed the cat, but it can save a human. Ron

There is a lot of confusion when it comes to what causes shingles type rashes. These rashes are medically known as "herpes zoster" because they are cause by the same varicella-zoster virus that causes chicken pox. There is no shingles virus by itself. Instead, shingles is caused by the same chicken pox virus someone was exposed to earlier in life. After you get chicken pox and recover from it the virus causing it never really goes away. It stays hidden out in your body until years later when it re-emerges causing shingles and the shingles rash. If this rash does break out it's important to remember that although you cannot pass shingles on to another person, the liquid in the rash blisters does contain the active chicken pox virus. That means you can pass chicken pox on to someone else, especially those most vulnerable, the very young, very old or those with immune system issues that weren't exposed to chicken pox in the past or that did not get the chicken pox vaccine. Although most of the time shingles does break out into a rash it's possible that the rash won't erupt and instead someone will only notice pain in certain body areas. This pain, and the rash, are on one side of the body and tend to follow a band like pattern either wrapping around your trunk or moving up or down a limb. Whether a rash or simply the pain associated with shingles, treatment can be used to help ensure the pain doesn't endure beyond the limited time of the outbreak itself.

Question #2
It is that time of year again when ticks start coming out. There are a lot of "old wives tales", but what is the best way to remove a tick? Does DEET work as a tick repellent? Thank you Kent

This is the time of the year when we start to experience more tick bites. This happens both because ticks start to get more active with the warmer weather and we start to get more contact with them because we are going outside more this time of the year. This combination means we'll be getting more tick bites. Unfortunately ticks can spread disease and the longer they stay attached to our skin the more likely it is that'll they'll cause problems. So removing them as soon as possible is important for both us and our children. Before venturing outdoors some things you can do to minimize tick bites include wearing light colored clothing and long pants you tuck into your boots. Deet, at 20% concentrations or higher can provide some protection against tick bites but won't eliminate them all. Permetherin is also approved for this purpose but should only be used on clothing and not directly on the skin. If you do find an attached tick don't try any of the "old wives tales" including putting petroleum jelly on the tick or burning it with a match. These techniques can cause the tick to regurgitate its stomach contents into your skin which can increase your chances of getting infections. The best way to get rid of the tick is to use small tweezers and grasp the tick as close to your skin as possible. Then use steady, even upward pressure until the tick is detached. Do not jerk the tick off as this will increase the chances of leaving behind mouth parts that are imbedded in the skin. Once the tick is removed clean the area, and your hands, with soap and water or rubbing alcohol.

Question #3
Dr. Torres, I was finally diagnosed with Celiac Disease after 8 years of doctors trying to figure it out! I realize the symptoms mimic a lot if other diseases, but a simple blood test is definitive. Since more and more people are showing up with this or 'gluten intolerance' why don't more doctors use this blood test especially since this disease is hereditary? Also will the pain and diarrhea eventually abate and the intestines heal following a GF diet? Judy

There are two different conditions that we need to discuss. The first is Celiac Disease. With this condition the body's own immune system attacks the small intestine when gluten is eaten damaging it's lining. Celiac disease can be detected with a simple blood test that is up to 90% accurate. On the other hand there is no one test that can detect gluten sensitivity effectively. It's also known as non celiac gluten sensitivity and someone affected with it tends to have symptoms similar to those with Celiac Disease but without the changes to the intestines or the positive blood tests. Symptoms of gluten sensitivity can also be non-descript things like headaches or increased fatigue. Gluten sensitivity cannot usually be detected by a blood test so often times a food elimination trial will be done. This is accomplished by eliminating gluten from the diet and seeing if symptoms improve. With both Celiac Disease and gluten sensitivity eliminating gluten from the diet will help improve symptoms. Healing of the intestine, in the case of Celiac Disease, will take place but could take weeks or even months once gluten is removed from the diet.


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