Dr Fred Kavalier: A question of health

I am a 50-year-old male, and I have been sexually attracted to young boys since my early teens, although fortunately I have never actually sexually abused a boy. I know that sexual intimacy with young boys cannot be tolerated, but at the same time a caring society must recognise that paedophiles need treatment for a condition they are forced to live with. No one asks, or chooses, to be a paedophile. Paedophilia causes me great personal distress and a lack of self-worth, together with enormous feelings of guilt. It has destroyed my life. Is there any known cause for it? Is it true that most paedophiles were themselves sexually abused as children? Is there any organisation in the UK that offers help to paedophiles, through counselling, therapy and the hand of friendship?

Can anyone help me?

I am a 50-year-old male, and I have been sexually attracted to young boys since my early teens, although fortunately I have never actually sexually abused a boy. I know that sexual intimacy with young boys cannot be tolerated, but at the same time a caring society must recognise that paedophiles need treatment for a condition they are forced to live with. No one asks, or chooses, to be a paedophile. Paedophilia causes me great personal distress and a lack of self-worth, together with enormous feelings of guilt. It has destroyed my life. Is there any known cause for it? Is it true that most paedophiles were themselves sexually abused as children? Is there any organisation in the UK that offers help to paedophiles, through counselling, therapy and the hand of friendship?

Although I have worked in UK general practice for 15 years, and I have had a number of patients who admitted to me that they were paedophiles, I have never before been asked the questions that you ask. Nearly everything that is written about paedophilia concentrates on the victims. Treatment of paedophiles and sexual offenders tends to take place in prisons and other high-security establishments. There are a number of forensic psychiatry departments throughout the UK that try to help paedophiles, but facilities are very limited and there is no accepted way of treating people. Some centres concentrate on long-term psychotherapeutic techniques, while others attempt to use drugs that reduce sexual desires. Despite extensive research, I have been unable to locate any self-help or counselling organisations in the UK that offer services to paedophiles who have not been convicted of a crime. There is a professional organisation – the National Organisation for the Treatment of Abusers – but this is a group of professionals who work in the field. In the US there is an organisation called Stop it Now! A UK branch with a telephone helpline should be set up soon.

Swollen arteries

I have been told that I have temporal arteritis and was prescribed an anti-inflammatory drug called rofecoxib. Apart from being told that it is inflammation in the head, I know little more. What other treatment could I have. Can it be cured? I get a burning pain in my left temple and eye, which is somewhat alarming.

Temporal arteritis is also known as giant cell arteritis and cranial arteritis. It causes inflammation and swelling of medium-sized arteries, such as the temporal artery that runs along the side of the skull between the eye and the ear. For some unknown reason this artery and other nearby arteries become inflamed. If the inflammation becomes severe, the artery becomes blocked. This leads to a loss of blood supply which, in its most severe form, can cause sudden blindness. Other symptoms include headache, unexplained fever, and weight loss. Temporal arteritis is sometimes associated with another condition called polymyalgia rheumatica (PMR). This causes severe pain and stiffness in muscles. Both conditions affect older people much more commonly than the young and middle-aged. The standard treatment for temporal arteritis and PMR is a long course of steroids. Rapid treatment with steroids in temporal arteritis can sometimes prevent loss of sight. The conditions usually burn themselves out after a couple of years. When this happens, steroid treatment can be stopped.

Food intolerance

About five years ago I realised that I had acquired an intolerance of eating rabbit. About three hours after eating rabbit I would suffer violent vomiting, but then an hour later I would feel quite normal again. Recently I have experienced the same problems after eating some mixed shellfish dishes. I am not sure which variety causes the trouble but it's not crab or prawns, which I have eaten on their own. Is the condition likely to spread to an intolerance of other foods, and, if so, is it possible to predict which foods? How common is this type of food intolerance?

Food intolerance that leads to violent vomiting is not very common. When it does occur, shellfish is frequently the cause. I must admit that I have never come across anyone who is violently intolerant of rabbit. I think you would be very unlucky if the intolerance spread to other foods. A number of private laboratories claim to be able to diagnose food intolerance with blood tests, but these tests tend to be both expensive and unreliable.

Have your say

The cystitis debate continues unabated.

HD writes: I have suffered from cystitis for many years and was treated with nitrofurantoin, but this drug has caused a peripheral neuropathy in my feet. This is often very painful. The usual self-help methods had no effect. I finally found real help by consulting a properly registered British medical herbalist, not a homeopath, and not a Chinese herbalist.

DF writes from Germany: I had to endure cystitis for years. My GP told me that I would just have to "live with it". I recently moved to Germany, and frankly the treatment I have received here makes me wonder what is going on in Britain. On my first visit to the doctor, I was prescribed the usual antibiotics. As soon as the second attack of cystitis occurred, I was prescribed Uro-Vaxom capsules made by Sanofi-Synthelabo GmbH of Berlin. These capsules work on the same principle as a vaccination. In Germany this is a standard treatment, and I would be very interested to know why it is not available in Britain.

Please send your questions and suggestions to A Question of Health, 'The Independent', Independent House, 191 Marsh Wall, London E14 9RS; fax 020-7005 2182 or e-mail to health@independent.co.uk. Dr Kavalier regrets that he is unable to respond personally to questions