DEAR DR. DONOHUE: Many of my elderly patients complain of flatus throughout the day. Elderly female patients are very embarrassed when this occurs.

Is there anything they can do to prevent this? Can Beano minimize the problem? – E.V.

ANSWER: Intestinal gas (flatus) is not a problem restricted to the elderly. It’s a universal problem for which there is no universal answer. Perhaps some facts can clear the air – so to speak.

Every single soul produces gas, and the daily amount varies between .5 pint and 2 quarts. Partly, gas comes from swallowed air. If prodigious gas-producers slow their eating and drinking, they gulp less air and produce less gas. It also helps to cut down on carbonated beverages and to go easy with chewing gum.

The major gas volume comes from colon bacteria that ferment undigested carbohydrates. The list of foods containing indigestible carbohydrates is long, and trying to avoid all of them is impractical and unhealthy. I’ll mention a few of the more notorious culprits. People can pick some off the list and see if their problem lessens by taking them off their menus for a time. Beans (everyone’s favorite joke), broccoli, brussels sprouts, cabbage, cauliflower, peas, bran, whole grains, bagels, pretzels and peanut butter rank high on the list of gassy foods. Some people are sensitive to dairy products, a fact that can be discovered only by eliminating them and noting the results. Sorbitol, a sweetener found in sugarless candies, gums and many commercial baked goods, stimulates gas production in many.

Beano does work for many people, and it works not just for beans. It has an enzyme that breaks down indigestible carbohydrates. No one will be the worse off for trying it. Other products are also worth a try. Maximum Strength Mylanta Gas, Flatulex and Gas-X are a few of the many products that fill the shelves of all drugstores.

DEAR DR. DONOHUE: I was diagnosed recently with MAC – mycobacterium avium complex. Very few people know of this disease. Can you enlighten me as to how it starts? Any information you can give will be helpful. I am on three antibiotics now. – M.R.

ANSWER: Mycobacterium avium complex is a strain of germs closely related to the TB germ. The infection it causes is not TB. Be clear about that. Nor is it spread like TB – from person to person. These germs are found in many places – water, soil and animals – and they can be acquired through inhalation or ingestion.

Most people with MAC germs never get an infection. The germs live with the person in peaceful coexistence.

In a few instances, the germs do cause an infection, and for those with a healthy immune system, the most common infection is a lung infection. Symptoms include cough, weight loss, weakness, fever and night sweats. X-rays show a typical pattern of lung involvement. Finding the germ in a sputum specimen is not evidence of infection. The person must also have typical MAC symptoms and X-ray changes consistent with infection.

Infected, ill people are faced with a prolonged commitment to treatment, usually with three antibiotics. Successful treatment can take as long as two years.

I need to add an important addendum about MAC infections. In people whose immune systems are not functioning normally, such infections can be widespread throughout the body and cause debilitating symptoms.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475.