Dear Dr. Gott: I have been diagnosed with ischemic colitis. It comes on fast and without warning. I'm concerned about my diet and thank you in advance for any information you might be able to provide.

Reply: Ischemic colitis is caused by an impaired flow of blood to the colon. It presents with low-grade fever, nausea, vomiting, diarrhoea, pain (commonly on the left side of the abdomen) and blood in the stool. The risk of complications exacerbates when the right side of the abdomen is affected. With arterial blockage, the small intestine fails to receive an adequate blood supply, and symptoms occur. Chronic cases are often associated with atherosclerosis, a buildup of plaque in the arteries.

Ischemic colitis can be related to conditions such as diabetes, vasculitis, abdominal radiation therapy, colon cancer and more. While rare, certain medications can cause symptoms of ischemic colitis as a side effect.

Testing for confirmation of the diagnosis can include colonoscopy, barium enema, biopsy, MRI and CT scan. A common approach once the diagnosis has been made is for a physician to prescribe medication to keep blood pressure readings normal.

A low-fat diet should be consumed, and additional fluids are recommended. Because you don't go into detail on your diet, I cannot comment as to whether it is appropriate. Speak with your physician or gastroenterologist for his or her recommendations.

The good news is that most cases are reasonably mild and will resolve without treatment within two days. However, when this fails to occur, a physician should be consulted as soon as possible thereafter.

To provide related information, I am sending you a copy of my Health Report 'Coronary Artery Disease'. Other readers who would like a copy should send a self-addressed stamped number ten envelope and a $2 cheque or money order to Newsletter, PO Box 167, Wickliffe, Ohio 44092. Be sure to mention the title.

Dear Dr. Gott: I am a 63-year-old female recently diagnosed with small bowel bacterial overgrowth (SBBO). I endured 18 months of suffering and testing before the diagnosis was made.Can you please tell me about this condition and any food restrictions I should follow? I know sugar can worsen symptoms.

Reply: The large intestine should contain a lot of bacteria, while the small has less. When SBBO develops, the bacteria use many of the nutrients that should be used by the body, leading to possible malnutrition. It may also lead to cell damage of the intestinal wall.

Some of the causes of SBBO include immune disorders, short bowel syndrome, disorders that slow small bowel movement, certain surgical produces and small bowel diverticulosis.

Symptoms include weight loss, diarrhoea, bloating, fullness, fatty/floating stools and abdominal pain and cramps. Severe cases may lead to osteoporosis, dehydration, liver disease and excess bleeding due to vitamin deficiency.

Some cases may benefit from antibiotic therapy or drugs that speed up intestinal movement. It is also important to get plenty of fluids and nutrients. For people who are already malnourished or dehydrated, hospitalisation may be necessary in order to administer intravenous nutrients and fluids.

As for diet, I am not aware that any specific foods will worsen or improve symptoms, but this is a question best asked of your personal physician. You should be under the care of a gastroenterologist if you are not already.

Dr. Peter Gott is a retired physician and the author of 'Dr. Gott's No Flour, No Sugar Diet' and 'Dr. Gott's No Flour, No Sugar Cookbook'. Contact him c/o United Media, 200 Madison Avenue, fourth floor, New York, New York 10016.