DEAR DR. ROACH: I love popcorn, but when you look close there are so many hard hulls! Are they hard on the stomach?  Can you eat too much? — G.P.P.

ANSWER: Popcorn has a lot of fiber, include the nondigestible bran of the kernel (also called the hull). Fiber is generally healthy for you, aiding in digestion and making you feel fuller, and foods high in fiber may reduce risk of some chronic diseases.

However, too much fiber, especially if your system is not used to it, is absolutely a potential problem. It can cause bloating and gas, and in rare instances can cause an obstruction in the bowel. This is not likely with any reasonable amount of popcorn.

Doctors used to think that in people with diverticulosis, which is little outpouchings in the wall of the colon, popcorn could cause diverticulitis (inflammation and infection). However, recent studies have shown this is unlikely.

Finally, enjoy popcorn air-popped, without oil or butter or too much salt, for the healthiest option.

***

DEAR DR. ROACH: I was recently worked up for an autoimmune disease that now seems to be osteoarthritis. I was placed on 10 mg of prednisone for 14 days with amazing relief from my painful shoulder and arms. I am severely allergic to aspirin and do not want to take opioids. The physician has ordered prednisone 2.5-5 mg daily to control symptoms. Is it safe to take this low dose of prednisone daily for pain control? — M.O.

ANSWER: It sounds to me that the physician may not have communicated as effectively as I might have hoped. Osteoarthritis, although a widespread cause of joint pain, is not an autoimmune disease, and it is not treated with prednisone. Instead, it sounds very much like you may have polymyalgia rheumatica.

PMR is found in women more often than in men and rarely in people under 50, most commonly in a person’s 70s. Hallmark symptoms are joint pain, especially of the shoulders and upper arms, that is much worse in the morning. PMR also is very sensitive to prednisone 10-20 mg: If it doesn’t respond dramatically to those kinds of doses, it probably isn’t PMR. A laboratory finding, the erythrocyte sedimentation rate, is almost always very elevated (92 percent-94 percent) in PMR. A different blood test for inflammation, C-reactive protein, is abnormal in 99 percent of people with the condition.

Treatment is low-dose prednisone, usually given at 10-20 mg per day to start, as long as it is controlling symptoms. About half of people will be able to come off of medication after a year or two, but some people continue on treatment for six years or more. Unfortunately, even at these low doses, roughly half of people can develop a side effect due to the steroids, especially cataracts. People on long-term steroids should have careful monitoring of blood pressure, sugar and cholesterol levels, as well as bone density. Alternate treatments that don’t rely on steroids are in development.

Dr. Roach regrets that he is unable to answer individual questions, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu.

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