DEAR DR. DONOHUE: When will the medical profession do some research on debilitating irritable bowel syndrome? I know a woman whose condition is so bad that she cannot control defecation. She has seen many doctors and has had many tests. I cannot believe that anyone has had to live under such conditions for so many years. What help is there? – P.R.

ANSWER: Irritable bowel syndrome is one of the most common digestive-tract maladies, but it usually does not reach the proportions your friend’s condition has.

Some experts believe that it comes from overactivity of the muscles of the intestine’s wall. Others feel it might be a disruption of the normal bacteria that populate the intestine. No one knows for sure.

Abdominal pain is its predominant symptom, along with a change in the pattern of bowel movements. People either become constipated, develop diarrhea or suffer from episodes of constipation alternating with episodes of diarrhea.

What medicines has she tried? Dicyclomine can sometimes control the erratic intestinal muscle contractions of IBS. Loperamide, an anti-diarrhea medicine, can control loose stools. Antidepressants like imipramine can be helpful – not for their antidepressant action but for their action on the digestive tract. Researchers are investigating probiotics – live bacteria or bacterial products – and one bacterium, bifidobacterium infantis, shows some promise. This is, of course, preliminary and not yet available for general use.

Lotronex is a possible treatment for a person with symptoms as distressing as your friend’s. It is prescribed for women with severe IBS diarrhea unresponsive to all other medicines. The prescribing doctor must be enrolled in the manufacturer’s special program, and the patient who takes it must be informed of all the side effects of the medicine, some of which can be serious.

DEAR DR. DONOHUE: Will you explain “whole grain”? I see this term all over the place. I happen to be very conscious about healthy eating, but the meaning of the term is never given. Thank you. – K.S.

ANSWER: Grains – wheat, oats, rye, barley and the rest – all have a similar structure. They have an outer coat – bran. It has some B vitamins and a few antioxidants, but most importantly it is the source of fiber, the stuff that keeps the digestive tract regular.

Most of the inner part of a grain is taken up by endosperm. It’s starch with a little protein.

The third part of a grain, also found inside, is the germ – its seed. When the germ is fertilized with pollen and put in the ground, it springs into a new plant. The germ also has nutrients: B vitamins, proteins, minerals and some good fats.

Whole grain is grain that has all three parts: bran, endosperm and germ.

Refining grains is a recent innovation in humankind’s long history of eating grains. Refining removes the outer bran coat and the germ. They’re tossed aside. All that’s left is the starchy endosperm, from which flours are made.

It’s taken us a little time, but we now know that the whole grain – all three components – is the most healthful way to consume grains.

DEAR DR. DONOHUE: I am a 33-year-old mother of four children, and I have pityriasis rosea. I thought this was strictly a children’s disease. I don’t feel sick, and the rash doesn’t bother me. Can I give it to my kids? – P.J.

ANSWER: Pityriasis (PIT-uh-RYE-uh-siss) rosea is a very common skin rash whose cause is unknown, so it is also unknown how it spreads. It might be a viral infection. I can’t say whether or not you can give it to your kids. Most commonly it occurs between the ages of 10 and 35, but infants have gotten it, as have people in their 70s. It consists of an eruption of salmon-pink patches, most prominently on the trunk, upper arms and upper legs.

Treatment is rarely needed. In instances when it itches, antihistamine or cortisone creams can usually control the itch. It goes away on its own in a matter of weeks.

DEAR DR. DONOHUE: Our 11-year-old son was complaining of ear fullness for two months. After many doctor visits without getting an answer, we took him to a specialist, who diagnosed a cholesteatoma. Can you explain it? What causes it, and what is the appropriate action? – C.M.

ANSWER: A cholesteatoma (COE-less-TEE-uh-TOE-muh) is a cystlike growth in the middle ear or in the bone adjacent to it. Such growths almost always enlarge. They can destroy the middle-ear structures and can deafen the involved ear.

Cholesteatomas arise from middle-ear infections. They can also emerge as a result of holes in the eardrum or from trauma to the ear. They might be present from birth.

Most often the treatment for a cholesteatoma is surgical removal. That preserves hearing.

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. Readers may also order health newsletters from www.rbmamall.com.